Low-dose weekly paclitaxel for recurrent or refractory aggressive non-Hodgkin lymphoma.
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.
Rizzieri
David A
DA
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
Sand
Gregory J
GJ
McGaughey
Dean
D
Moore
Joseph O
JO
DeCastro
Carlos
C
Chao
Nelson J
NJ
Vredenburgh
James J
JJ
Gasparetto
Cristina
C
Long
Gwynn D
GD
Anderson
Elizabeth
E
Foster
Tracy
T
Toaso
Bonnie
B
Adams
Donna
D
Niedzwiecki
Donna
D
Gockerman
Jon P
JP
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
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel