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Annals of Oncology 4:251-253, 1993
© 1993 European Society for Medical Oncology

other

Effective salvage chemotherapy in relapsed or refractory non-Hodgkin's lymphoma

R. Buzzoni, M. Colleoni, E. Bajetta, F. Nolè, P. Nelli, C. A. De Palma and F. de Braud

Department of Medical Oncology, Istituto Nazionale per lo Studio e la Cura dei Tumori Milan, Italy

Roberto Buzzoni MD, Department of Medical Oncology, Istituto Nazionale Tumori, Via Venezian 1, 20133 Milano, Italy

BACKGROUND: Over the last few years, high-dose chemotherapy has been extensively investigated in relapsing/refractory non-Hodgkin's lymphoma (NHL). However, this approach is reserved to a limited subset of cases and new conventional-dose second-line chemotherapies need to be investigated.

PATIENTS AND METHODS: Thirty consecutive out-patients with refractory or recurrent NHL were given polychemotherapy in a regimen consisting of ifosfamide, mitoxantrone and etoposide on day 1 and vindesine, cisplatinum and cytosine arabinoside on day 15: courses were repeated every 29 days. Five patients had refractory disease following first-line chemotherapy and 25 were relapsing.

RESULTS: The median number of administered cycles was 4 (range 2–8). We observed 16 complete (53%; 95% confidence interval, 34%–72%) and 3 partial remissions, for an overall remission rate of 63% (95% confidence interval, 44%–80%). Responses were seen only among patients who achieved at least a partial response during first-line therapy. The median duration of complete remission was 15 months (range 5–47+), whereas median survival of the treated patients was 26 months (range 2–50+). Five patients were long-term responders after 34+, 35+, 46+, 46+ and 47+ months. No-life threatening toxicity was observed. The main side effects were myelosuppression, nausea/vomiting and alopecia.

CONCLUSIONS: The proposed regimen is feasible and effective in terms of complete remission rate and disease-free survival, suggesting that this treatment may be potentially curative in a subgroup of relapsed patients with limited tumor burden and normal LDH values. A more aggressive approach is needed in refractory patients.

non-Hodgkin's lymphoma, salvage chemotherapy


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