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Annals of Oncology 6:609-612, 1995
© 1995 European Society for Medical Oncology

brief-report

A phase II trial of mesna/ifosfamide, mitoxantrone and etoposide for refractory lymphomas

M. A. Rodriguez, F. C. Cabanillas, F. B. Hagemeister, P. McLaughlin, J. E. Romaguera, F. Swan and W. Velasquez

Department of Hematology, The University of Texas M.D. Anderson Cancer Center Houston, TX, U.S.A.

Correspondence to: M. Alma Rodriguez, M.D. U.T. M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 68, Houston, TX 77030, USA.

BACKGROUND: We have previously reported that combination chemotherapy based on the drugs cytarabine/platinum is effective in recurring lymphomas. In this phase II study, we prospectively studied a combination regimen of mesna/ifosfamide, mitoxantrone and etoposide (MINE) in patients with recurring lymphoma who had already received cytarabine/ platinum but did not respond to the treatment.

PATIENTS AND METHODS: 48 patients received MINE at the following doses: mesna 1.33 g/m2 IV daily x3, and 500 mg p.o. daily 4 hours after each IV dose; ifosfamide 1.33 g/m2 IV daily, given concurrently with mesna, x3 d; mitoxantrone 8 mg/m2 IV on day 1; and etoposide 65 mg/m2 IV daily x3. Treatment cycles were 21–28 days apart, depending on patients' blood counts, with a maximum number of 6 cycles in responding patients. The histologic grade of the lymphomas according to the Working Formulation was low in 8 patients and intermediate in 40 patients. In the latter group, 12 were transformed from low grade.

RESULTS: Overall, 48% of the patients responded, with 21% having a complete response (CR), and 27% having a partial response (PR). The median survival time was 9 months, and the median follow-up of survivors is 51 months at this writing. Median time to treatment failure was 12 months for patients with complete responses, and 5 months for patients with partial responses. The most serious complication was myelosuppression, with 2 deaths resulting from neutropenic infection.

CONCLUSION: The MINE regimen induced responses in a moderate fraction of patients after their prior exposure to cytarabine/platinum salvage therapy, indicating there is no absolute cross resistance between these drug regimens.

ifosfamide, salvage therapy, lymphoma


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