Mitoxantrone, carboplatin, cytosine arabinoside, and methylprednisolone followed by autologous peripheral blood stem cell transplantation: a salvage regimen for patients with refractory or recurrent non-Hodgkin lymphoma.
BACKGROUND
The objective of the current study was to evaluate a salvage chemotherapy regimen consisting of mitoxantrone, carboplatin, cytosine arabinoside, and methylprednisolone (MiCMA) for the treatment of patients with primary refractory or recurrent non-Hodgkin lymphoma (NHL).


METHODS
From September 1991 to August 2002, 94 consecutive patients ages 16-60 years who had either recurrent or refractory NHL (mainly diffuse large-cell lymphomas) were treated on the MiCMA protocol. Patients had peripheral blood stem cells collected successfully for autologous stem cell transplantation after two or three cycles of MiCMA.


RESULTS
Sixty-four of 85 evaluable patients achieved a response to the MiCMA regimen: 24 patients (26%) achieved a complete response and 40 patients (44%) achieved a partial response, for a total response rate of 70%. Sixty-two patients underwent autologous stem cell transplantation. After a median follow-up of 58 months, 47 patients (55%) remained alive; among these patients, 32 were free of disease (37%). No toxic deaths related to MiCMA were observed. Three patients died of infectious complications after transplantation.


CONCLUSIONS
The current results suggested that MiCMA chemotherapy is an effective therapeutic alternative salvage regimen for patients with primary refractory or recurrent NHL. Response rates, overall survival, and freedom from disease progression were found to be associated significantly with response to MiCMA. Peripheral blood stem cell transplantation was feasible in virtually all patients, and its outcome was influenced strongly by chemosensitivity.
Sorá
Federica
F
Istituto di Ematologia, Universita Cattolica del Sacro Cuore di Roma, Italy. emacat@rm.unicatt.it
Piccirillo
Nicola
N
Chiusolo
Patrizia
P
Laurenti
Luca
L
Marra
Roberto
R
Bartolozzi
Francesco
F
Leone
Giuseppe
G
Sica
Simona
S
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D036102:Peripheral Blood Stem Cell Transplantation; D012008:Recurrence; D016879:Salvage Therapy; D014182:Transplantation, Autologous
D003561:Cytarabine; D016190:Carboplatin; D008942:Mitoxantrone; D008775:Methylprednisolone