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Combined ifosfamide, etoposide and oxalipatin chemotherapy, a low‐toxicity regimen for first‐relapsed or refractory Hodgkin lymphoma after ABVD/EBVP: a prospective monocentre study on 34 patients
Author(s) -
Sibon David,
Ertault Marjane,
Al Nawakil Chadi,
de Bazelaire Cédric,
Franchi Patricia,
Brière Josette,
de Kerviler Eric,
Beranger Nathalie,
Thieblemont Catherine,
Brice Pauline
Publication year - 2011
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.1365-2141.2011.08594.x
Subject(s) - medicine , abvd , ifosfamide , etoposide , dacarbazine , regimen , salvage therapy , autologous stem cell transplantation , surgery , chemotherapy , chemotherapy regimen , febrile neutropenia , transplantation , neutropenia , gastroenterology , vincristine , cyclophosphamide
Summary Around 20% of Hodgkin lymphoma (HL) patients are refractory to first‐line therapy with ABVD (adriamycin–bleomycin–vinblastine–dacarbazine) or relapse after complete remission. Salvage regimens frequently have delayed courses or require dose‐reduction because of haemotoxicity. We evaluated the IVOx (ifosfamide–etoposide–oxaliplatin) salvage regimen in terms of response rate, toxicity and stem‐cell mobilization. Thirty‐four patients with relapsed/refractory HL after anthracycline‐containing chemotherapy prospectively received IVOx, consisting of ifosfamide (1500 mg/m 2 days 1–3), etoposide (150 mg/m 2 days 1–3) and oxaliplatin (130 mg/m 2 day 1). Patients <65 years old received high‐dose therapy followed by autologous stem‐cell transplantation (HDT–ASCT). Response was assessed by computed and positron‐emission tomographies. Overall and complete response rates were 76% and 32%, respectively, after 2 cycles. Three episodes of febrile neutropenia occurred, and three patients required dose‐reductions. Twenty‐six patients underwent HDT–ASCT. With median follow‐up at 5 years, the 5‐year overall and event‐free survival rates were 74% and 63%, respectively. IVOx is a well‐tolerated outpatient regimen for relapsed HL, that does not hamper stem‐cell mobilization, achieves good response rates and compares favourably with previously published salvage regimens.