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Ifosfamide, mitoxantrone and etoposide (VIM) as salvage therapy of low toxicity in non‐Hodgkin's lymphoma
Author(s) -
Hopfinger G.,
Heinz R.,
Koller E.,
Schneider B.,
Pittermann E.
Publication year - 1995
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/j.1600-0609.1995.tb00261.x
Subject(s) - ifosfamide , mitoxantrone , mesna , medicine , etoposide , toxicity , gastroenterology , salvage therapy , chemotherapy , lymphoma , refractory (planetary science) , surgery , progressive disease , non hodgkin's lymphoma , physics , astrobiology
Patients with non‐Hodgkin's lymphoma (NHL) who fail to respond to first‐line treatment or relapse after having shown complete or partial remission have a poor prognosis, especially in high‐grade NHL. Several salvage regimens show considerable toxicity and a poor long‐term outcome. In this retrospective study we analyzed data of 55 patients (34 men and 21 women) with a median age of 66 years (range: 18–89). The combination chemotherapy (VIM) consisted of VP‐16 (etoposide) 65 mg/m 2 , ifosfamide 650 mg/m 2 and mitoxantrone 3 mg/m 2 and was administered on 3 consecutive days along with mesna as uroprotection. Patients were treated for refractory disease or relapse and did not qualify for high‐dose chemotherapy and ABMT. Stages according to the An Arbor classification were: stage I/16, II/4, III/8 and IV/37 patients. Thirty‐three patients suffered from high‐grade and 22 from low‐grade NHL. Toxicity (WHO recommendations) was very mild. High‐grade NHL showed a better response rate (18/33, 46%) than low‐grade NHL (7/22, 36%). Overall response was 41% (12 CR and 11 PR) with a median duration of 36 months (range: 6–57 months). The combination therapy investigated exhibits mild toxicity even in extensively pretreated or elderly patients. The overall response rate of 41% might be improved by increased dosage and growth factor support.