title: A phase-II study with idarubicin, ifosfamide and VP-16 (IIVP-16) in patients with refractory or relapsed aggressive and high grade non-Hodgkin's lymphoma.
abstract: We report a phase-II study of idarubicin, ifosphamide and etoposide (IIVP-16) in heavily pretreated patients with relapsed or refractory aggressive non-Hodgkin's lymphoma. The IIVP-16 regimen consisted of idarubicin (10 mg/m2 i.v. days 1 + 2 or days 1 + 8), ifosfamide (1000 mg/m2 i.v. days 1-5) and VP-16 (150 mg/m2 i.v. days 103). 40 patients were enrolled. Of 38 evaluable patients, 26 had centroblastic subtype, followed by lymphoblastic (6), immunoblastic (2), and other entities (4). 18 patients were primary resistant; 14 patients had early relapse (CR less than 12 months) and 8 patients late relapse (CR longer than 12 months). The median number of different prior chemotherapy regimens was 2 (range 1 to 6). 20 patients had received additional radiotherapy. The response-rate was 47.4% including 8 CR (21.1%) and 10 PR (26.3%). IIVP-16 was more effective in patients with relapsed disease when compared with patients with primary resistant disease (response rate 65% vs. 27.8%, p < 0.025). Leukopenia and thrombocytopenia were the major toxicities occurring in 73/107 (68.2%) and 57/107 (53.3%) of cycles (WHO grade IV). IIVP-16 is an effective regimen particularly in patients with unfavorable relapsed NHL.
authors.affiliation: Klinik I für Innere Medizin, Universität zu Köln, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Engert
authors.forename: R
authors.initials: R
authors.lastname: Schnell
authors.forename: F
authors.initials: F
authors.lastname: Küpper
authors.forename: M
authors.initials: M
authors.lastname: Reiser
authors.forename: M
authors.initials: M
authors.lastname: Engelhard
authors.forename: M
authors.initials: M
authors.lastname: Wilhelm
authors.forename: B
authors.initials: B
authors.lastname: Lathan
authors.forename: S
authors.initials: S
authors.lastname: Baltes-Engler
authors.forename: B
authors.initials: B
authors.lastname: Winterhalter
authors.forename: M E
authors.initials: ME
authors.lastname: Scheulen
authors.forename: B
authors.initials: B
authors.lastname: Dederichs
authors.forename: H
authors.initials: H
authors.lastname: Tesch
authors.forename: B
authors.initials: B
authors.lastname: Wörmann
authors.forename: V
authors.initials: V
authors.lastname: Diehl
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003630:Daunorubicin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000097:blood / Q000493:pharmacokinetics; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics; D007069:Ifosfamide / Q000008:administration & dosage; D007206:Individuality; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged
chemical_list: D005047:Etoposide; C054440:idarubicinol; D007069:Ifosfamide; D015255:Idarubicin; D003630:Daunorubicin