title: Low-dose weekly paclitaxel for recurrent or refractory aggressive non-Hodgkin lymphoma.
abstract: BACKGROUND
  Many patients with recurrent, intermediate or high-grade non-Hodgkin lymphoma (NHL) may not respond to or are not candidates for aggressive salvage chemotherapy. Effective, less toxic regimens are needed. Although high-dose taxanes have not been reported to be very effective for the treatment of lymphoma, different delivery rates may allow for different mechanisms of action to be manifest and result in a different toxicity profile and response rate. The current study tested this hypothesis by using low-dose, weekly paclitaxel in patients with recurrent or refractory NHL.
  
  
  METHODS
  Adults age > 18 years with refractory or recurrent, aggressive NHL who were not considered curable with standard high-dose therapy received paclitaxel at a dose of 80 mg/m2 weekly for 5 weeks for 2 cycles.
  
  
  RESULTS
  Thirty-four patients with refractory NHL and 4 patients with recurrent disease were treated. Approximately 45% of the patients had achieved a prior disease remission. The median number of prior regimens received was 3, 74% of the patients had an International Prognostic Index of > or = 3 at the time of study entry, and 29% had failed high-dose therapy with autologous hematopoietic support. Only one patient encountered severe toxicity (sepsis). Myelosuppression was reported to occur in approximately 20% of patients. A total of 10 patients (26%) achieved a complete disease response and 4 patients (11%) achieved a partial response.
  
  
  CONCLUSIONS
  In the current study, low-dose, weekly paclitaxel therapy was found to provide a well tolerated and less toxic approach to the treatment of refractory NHL, with encouraging responses noted in heavily pretreated patients. However, evaluation in patients with an earlier stage of disease is warranted.
authors.affiliation: Division of Medical Oncology and Transplantation, Duke University Medical Center, and the Duke Oncology Network, Duke University, Durham, North Carolina 27710, USA. rizzi003@mc.duke.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Rizzieri
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Sand
authors.forename: Dean
authors.initials: D
authors.lastname: McGaughey
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Moore
authors.forename: Carlos
authors.initials: C
authors.lastname: DeCastro
authors.forename: Nelson J
authors.initials: NJ
authors.lastname: Chao
authors.forename: James J
authors.initials: JJ
authors.lastname: Vredenburgh
authors.forename: Cristina
authors.initials: C
authors.lastname: Gasparetto
authors.forename: Gwynn D
authors.initials: GD
authors.lastname: Long
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Anderson
authors.forename: Tracy
authors.initials: T
authors.lastname: Foster
authors.forename: Bonnie
authors.initials: B
authors.lastname: Toaso
authors.forename: Donna
authors.initials: D
authors.lastname: Adams
authors.forename: Donna
authors.initials: D
authors.lastname: Niedzwiecki
authors.forename: Jon P
authors.initials: JP
authors.lastname: Gockerman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002277:Carcinoma / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D020714:Maximum Tolerated Dose; D008833:Microcirculation; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000473:pathology; D017239:Paclitaxel / Q000008:administration & dosage*; D012074:Remission Induction; D016879:Salvage Therapy
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel