[Treatment of lymphoma patients with fludarabine-based regimens: a report of 29 cases].
OBJECTIVE
Fludarabine is one of the most effective agents for indolent lymphoma and chronic lymphocyte leukemia (CLL). Response rate of single agent for chemotherapy-naive patients ranged from 40%to 87% with 14-60% complete remission (CR) rate has been reported abroad while the response rate of 30%-70% and the CR rate of 10%-38% for pre- treated patients. Significantly higher response rate can be yielded by combined regimen such as FN, FMD, and FC, etc. The purpose of this study was to investigate the efficacy and toxicity of fludarabine-based regimen for patients with lymphoma in China.


METHODS
Twenty-nine patients with lymphoma were enrolled into this study from April 2001 to December 2003. There were 18 male and 11 female patients with median age of 53 years old (ranged from 27 to 79). Twenty-two patients were low-grade lymphoma and 7 were intermediate-grade lymphoma. Nineteen patients had been treated by FMD(Fludarabine 25 mg/m(2) d1-3,Mitoxantrone 8 mg/m(2) d1 and Dexamethasone 20 mg d1-4) while 3 by R-FMD (Rituximab+FMD) and 7 by other fludarabine- containing regimens. The median therapeutic cycles were 3 (1-6).


RESULTS
Twenty-five patients were available for objective evaluation in 29 enrolled patients. The response rate and the CR rate for indolent group were 86% (18/21) and 38% (8/21). No response was obtained in 4 cases of intermediate grade lymphoma. Myelosuppression and mild GI toxicity were major side effects. The rates of leucopenia, thrombocytopenia, and anemia were 61% (III+IV, 8%), 18% (III+IV, 4%), and 26%, respectively. G-CSF was necessary only in 5% of cycles without red cell or platelet transfusion. Mild nausea and vomiting account for 20%. Five cases of febrile neutropenia during chemotherapy were controlled by intravenous antibiotics and supportive care. Transient liver function abnormality and jaundice encountered in 1 patient and diffusive skin rash in another one.


CONCLUSIONS
Fludarabine-based regimen is highly effective for indolent lymphoma with mild toxicity. Further investigation is warranted.
Huang
Hui-Qiang
HQ
Department of Medical Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, PR China. huanghq@pub.guangzhou.gd.cn
Jiang
Wen-Qi
WQ
Peng
Yu-Long
YL
Xia
Zhong-Jun
ZJ
Li
Yu-Hong
YH
Li
Xu-Bing
XB
Lin
Tong-Yu
TY
Sun
Xiao-Fei
XF
Guan
Zhong-Zhen
ZZ
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D014740:Vidarabine; C024352:fludarabine