Ifosfamide and VP-16213 combination chemotherapy combined with ablative chemotherapy and autologous marrow transplantation as salvage treatment for malignant lymphoma.
Eighteen patients with high-grade malignant lymphoma were treated with ifosfamide-VP16213 combinations after failing to respond completely or after relapsing on CHOP-like therapy. Responders to the salvage therapy were subsequently treated with ablative chemotherapy (BCNU, VP-16213, Ara-C and melfalan) and autografted. Of these 18 patients six were in relapse, six were partial responders and six failed CHOP-like therapy. There were two complete remissions and seven partial responses to the ifosfamide-VP-16213 combinations. Of them, eight patients were transplanted, together with one non-responder. Four of these nine patients were disease-free survivors 18-34 months after autografting. There were two early deaths: one before and one during the autografting procedure. Using one of the best salvage therapy combinations followed by high-dose chemotherapy and autografting is feasible. The results in this pilot study suggest that an appreciable number of patients may be cured by this procedure.
Huijgens
P C
PC
Department of Haematology, Free University Hospital, Amsterdam, The Netherlands.
Ossenkoppele
G J
GJ
van der Lelie
J
J
Thomas
L L
LL
Wijngaarden
M J
MJ
Reijneke
R M
RM
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D002330:Carmustine / Q000008:administration & dosage; D003131:Combined Modality Therapy; D003561:Cytarabine / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008223:Lymphoma / Q000188:drug therapy*; D008558:Melphalan / Q000008:administration & dosage; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D008935:Mitoguazone / Q000008:administration & dosage; D011034:Podophyllotoxin / Q000008:administration & dosage
D003561:Cytarabine; D005047:Etoposide; D011034:Podophyllotoxin; D008935:Mitoguazone; D008558:Melphalan; D002330:Carmustine; D007069:Ifosfamide; D008727:Methotrexate