High-dose ifosfamide and mitoxantrone (HDIM) in patients with relapsed or refractory Hodgkin's lymphoma

被引:3
|
作者
Aurer, Igor [1 ,2 ]
Nemet, Damir [1 ,2 ]
Mitrovic, Zdravko [2 ]
Dujmovic, Dino [2 ]
Basic-Kinda, Sandra [1 ]
Radman, Ivo [1 ]
Sertic, Dubravka [1 ]
Santek, Fedor [2 ,3 ]
Kralik, Marko [4 ]
Dotlic, Snjezana [5 ]
Mazic, Sanja [6 ]
Labar, Boris [1 ,2 ]
机构
[1] Univ Hosp Ctr Zagreb, Dept Internal Med, Div Hematol, Kispaticeva 12, Zagreb 10000, Croatia
[2] Univ Zagreb, Sch Med, Zagreb 41001, Croatia
[3] Univ Hosp Ctr Zagreb, Dept Oncol, Zagreb, Croatia
[4] Univ Hosp Ctr Zagreb, Dept Radiol, Zagreb, Croatia
[5] Univ Hosp Ctr Zagreb, Dept Pathol & Cytol, Zagreb, Croatia
[6] Univ Hosp Ctr Zagreb, Dept Transfus Med, Zagreb, Croatia
关键词
Hodgkin's lymphoma; Antineoplastic combined chemotherapy protocols; Ifosfamide; Mitoxantrone; Autologous stem cell transplantation; STEM-CELL TRANSPLANTATION; SALVAGE THERAPY; BRENTUXIMAB VEDOTIN; FREE SURVIVAL; CHEMOTHERAPY; 2ND-LINE; DISEASE; RISK; GEMCITABINE; RESISTANT;
D O I
10.1007/s00277-016-2676-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Relapsed/refractory Hodgkin's lymphoma (HL) is treated with salvage chemotherapy and autologous stem cell transplantation (ASCT). Optimal chemotherapy is unknown. We retrospectively analyzed outcomes of 58 patients treated with 2 cycles of high-dose ifosfamide and mitoxantrone (HDIM). HDIM consisted of ifosfamide 5 g/m(2)/day and MESNA 5 g/m(2)/day in continuous 24-h infusion (days 1 and 2), MESNA 2.5 g/m(2) over 12 h (day 3), and mitoxantrone 20 mg/m(2) (day 1) administered every 2 weeks. Stem cells were collected after the first cycle. Responding patients proceeded to ASCT. Toxicity was acceptable. Stem cell mobilization was successful in 96 % of patients. Overall response rate was 74 % (89 % in relapsing and 45 % in refractory patients) with 31 % complete remissions. After a median follow-up of 54 months, 5-year event-free survival was 56 % (69 % for relapsing and 35 % for refractory patients), and 5-year overall survival was 67 % (73 % for relapsing and 55 % for refractory patients). Significant adverse prognostic factors were refractoriness to previous therapy and HDIM failure. No differences in outcomes were noted between patients with early and late relapses or between complete and partial responders. HDIM is a well-tolerated and effective regimen for relapsed and refractory HL with excellent stem cell mobilizing properties. Patients failing HDIM may still benefit from other salvage options.
引用
收藏
页码:1129 / 1136
页数:8
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