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Ifosphamide, etoposide and epirubicin is an effective combined salvage and peripheral blood stem cell mobilisation regimen for transplant‐eligible patients with non‐Hodgkin lymphoma and Hodgkin disease
Author(s) -
Bishton Mark J.,
Lush Richard J.,
Byrne Jenny L.,
Russell Nigel H.,
Shaw Bronwen E.,
Haynes Andrew P.
Publication year - 2007
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2007.06498.x
Subject(s) - medicine , etoposide , epirubicin , gastroenterology , chemotherapy , neutropenia , lymphoma , transplantation , autologous stem cell transplantation , regimen , progressive disease , oncology , surgery , cyclophosphamide
Summary A total of 143 patients with relapsed ( n = 90), primary refractory ( n = 32) and first line chemotherapy responsive ( n = 21) non‐Hodgkin lymphoma (NHL) and Hodgkin disease (HD) were treated with IVE (ifosphamide, etoposide and epirubicin) chemotherapy with the intent to proceed to high‐dose therapy with either autologous or allogeneic transplantation, following peripheral blood stem cell mobilisation. A major response (complete/partial response) to IVE was seen in 115 patients (80·4%) with 5‐year overall survival (OS) and event free survival (EFS) of 53% and 43%, respectively. Subgroup analysis showed overall response rates of 93·1% for HD with a 5‐year OS and EFS of 62% and 52% respectively, while NHL showed response rates of 78·0% with 5‐year OS and EFS of 50% and 39% respectively. The median number of CD34 +ve cells mobilised following IVE was 7·86 × 10 6 (range 1·72–42·91 × 10 6 ), with 60% mobilising >2 × 10 6 /kg in a single collection. Grade IV neutropenia was seen in 79·6% patients and 77/270 cycles required intravenous antibiotic treatment. We conclude that IVE has a high response rate across a range of refractory and relapsed lymphoma with acceptable toxicity and excellent PBSC mobilising characteristics.