High-dose cytosine arabinoside in relapsed and refractory non-Hodgkin's lymphoma. Limited role as a single agent.
Cytosine arabinoside (ara-C) is an S-phase active antineoplastic agent used in the treatment of several hematologic malignancies. We did a retrospective analysis on 48 patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) who were treated with high-dose ara-C between 1982 and 1987. All patients received between 9 and 24 g/m2/course of treatment with 90% receiving 12g/m2/treatment. Fifteen patients (25%) achieved a complete or partial remission. Of these, five (10%) were complete responders. Long-term disease-free survival was maintained only in those responders who were consolidated with autologous bone marrow transplantation. Toxicity was primarily myelosuppression. Seventy-five percent of patients developed fever and neutropenia with an equivalent percent having severe thrombocytopenia sufficient to require platelet transfusion. Five patients (10%) had significant neurotoxicity. There were seven treatment-related deaths (15%). Patients in whom tumors contained a small cell component responded better than patients with purely large cell or undifferentiated lymphomas (50% versus 15%, P = 0.024). We conclude that high-dose ara-C given as 3g/m2 every 12 hours for four doses has a limited role when used as a single agent in the treatment of relapsed or refractory non-Hodgkin's lymphoma. However, there are subsets of patients who may respond favorably to this therapy.
Soiffer
R J
RJ
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115-0274.
Caligiuri
M A
MA
Tondini
C
C
Canellos
G P
GP
D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D003561:Cytarabine / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*
D003561:Cytarabine