title: VIP (etoposide, ifosfamide and cisplatinum) as a salvage intensification program in relapsed or refractory Hodgkin's disease.
abstract: Forty-two patients with refractory (15 patients) or relapsed (27 patients) Hodgkin's disease (HD) were included in a prospective single center study evaluating the efficacy of a regimen VIP combining etoposide 75 mg/m2/day days 1-5, ifosfamide 1.2 g/m2/day days 1-5 and cisplatinum 20 mg/m2/day days 1-5, one course every 4 weeks as salvage therapy in patients with refractory or relapsed Hodgkin's disease, potentially eligible for high-dose chemotherapy with reinjection of hematopoietic stem cells (HSC). If patients were considered chemosensitive after two courses of VIP, high-dose chemotherapy followed by the reinjection of HSC was planned. After two courses of VIP, 67% achieved an objective response including 38% complete responses. Overall, 28 patients went on to high-dose therapy with reinjection of HSC, and 46% of grafted patients are in a sustained complete remission. When the overall patient population is considered, 33% are in complete remission (CR) with a median follow-up of 37 months. A CR of less than 12 months and refractory disease were associated with a poor survival. These results showed that the VIP regimen is effective in relapsed or refractory HD and allows high-dose therapy to be given in the case of most responding patients. However, results in patients with refractory disease or a first complete remission of less than 12 months need to be further improved.
authors.affiliation: Service de Médecine C, Institut Gustave-Roussy, Villejuif, France.
authors.forename: V
authors.initials: V
authors.lastname: Ribrag
authors.forename: F
authors.initials: F
authors.lastname: Nasr
authors.forename: J H
authors.initials: JH
authors.lastname: Bouhris
authors.forename: J
authors.initials: J
authors.lastname: Bosq
authors.forename: P
authors.initials: P
authors.lastname: Brault
authors.forename: T
authors.initials: T
authors.lastname: Girinsky
authors.forename: J M
authors.initials: JM
authors.lastname: Cosset
authors.forename: J N
authors.initials: JN
authors.lastname: Munck
authors.forename: C
authors.initials: C
authors.lastname: Corti
authors.forename: D
authors.initials: D
authors.lastname: Decaudin
authors.forename: J L
authors.initials: JL
authors.lastname: Pico
authors.forename: M
authors.initials: M
authors.lastname: Hayat
authors.forename: P
authors.initials: P
authors.lastname: Carde
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D016879:Salvage Therapy
chemical_list: D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide