title: Shortened and intensified MJMA: an effective salvage therapy for relapsed and refractory lymphomas and a strong mobilizer of PBSCs.
abstract: There is great interest in chemotherapies for relapsed or refractory lymphomas that are both directly effective against the lymphoma and able to mobilize PBSCs for rescue after high-dose chemotherapy (HDC). Twenty-eight patients with relapsed or refractory lymphomas were treated with a shortened, intensified MJMA regimen (mitoxantrone 10 mg/m(2) i.v. day 1, carboplatin 200 mg/m(2) i.v. days 1-2, methylprednisolone 500 mg/m(2) i.v. days 1-3, cytarabine 2000 mg/m(2) i.v. day 3) for six cycles every 21 days. A median of five cycles/patient was administered. Nineteen patients had complete responses, seven partial responses and two no responses. The only remarkable toxicity was hematological. In 18 patients who were candidates for HDC, a mean of 10.45 x 10(6) CD34/kg of patients' body weight was collected (range: 3.70-24.88 x 10(6)/kg). Eleven patients underwent transplantation, which converted two of four partial responses into complete responses. The median follow-up was 49 months. Survival parameters were not related to relapsed/refractory status or to the time from the last chemotherapy, but were related only weakly to the number of prior chemotherapies. Outpatient MJMA is a feasible and very effective salvage chemotherapy per se. The complete response rate is high and it is a powerful PBSC mobilizer.
authors.affiliation: Clinica Medica I, Università di Pavia, Fondazione IRCCS Policlinico S Matteo, 27100 Pavia, Italy. gobbipg@smatteo.pv.it
authors.forename: P G
authors.initials: PG
authors.lastname: Gobbi
authors.forename: F
authors.initials: F
authors.lastname: Valentino
authors.forename: P
authors.initials: P
authors.lastname: Lambelet
authors.forename: V
authors.initials: V
authors.lastname: Perfetti
authors.forename: G
authors.initials: G
authors.lastname: Bergamaschi
authors.forename: M
authors.initials: M
authors.lastname: Girino
authors.forename: G R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D016190:Carboplatin / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells; D006689:Hodgkin Disease / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000378:metabolism / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage; D012008:Recurrence; D016879:Salvage Therapy; D015996:Survival Rate; D013997:Time Factors
chemical_list: D003561:Cytarabine; D016190:Carboplatin; D008942:Mitoxantrone; D008775:Methylprednisolone