Combination Salvage Chemotherapy with MIZE (Ifosfamide-Mesna, Idarubicin and Etoposide) for Relapsing or Refractory Lymphoma

Combination Salvage Chemotherapy with MIZE (Ifosfamide-Mesna, Idarubicin and Etoposide) for Relapsing or Refractory Lymphoma

In this study, 54 patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) were treated in a phase II, multicentric trial with ifosfamide-mesna 1500 mg/m2 IV days 1-3, idarubicin 12 mg/m2 IV day 1 and etoposide 100 mg/m2 IV day 1-3 (MIZE). Overall response was 72%; complete response (C...

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Bibliographic Details
Published in:Leukemia & lymphoma Vol. 26; no. 5-6; pp. 595 - 602
Main Authors: Garay, Guy, Dupont, Juan, Dragosky, Martha, Nucifora, Elsa, Cacchione, Roberto, Schnidrig, Pedro, Fefwández, José, Abel-Alzueta, Riveros, Dardo, Noviello, Vicenta, Bègueltn, Raül, Campestri, Reynaldo, Albera, Carlos, Nicastro, Mario, Triguboff, Eduardo
Format: Journal Article
Language:English
Published: United States Informa UK Ltd 1997
Taylor & Francis
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
etoposide
Etoposide - administration & dosage
Female
Humans
idambicin
Idarubicin - administration & dosage
ifosfamide
Ifosfamide - administration & dosage
Lymphoma, Non-Hodgkin - drug therapy
Male
Mesna - administration & dosage
Middle Aged
Recurrence
refractory lymphomas
Relapsing lymphoma
Salvage Therapy
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Summary:In this study, 54 patients with relapsed or refractory non-Hodgkin's lymphoma (NHL) were treated in a phase II, multicentric trial with ifosfamide-mesna 1500 mg/m2 IV days 1-3, idarubicin 12 mg/m2 IV day 1 and etoposide 100 mg/m2 IV day 1-3 (MIZE). Overall response was 72%; complete response (CR) and partial response (PR) were 46% and 26% respectively. In Stage I-II pts CR was 59% and in Stage III-IV pts CR was 40.5%. Patients who relapsed from an initial CR had a 64% CR rate when treated with MIZE, in contrast to refractory disease's patients who only had 19% CR (p = 0.004). The group of pts that had an objective response (CR + PR) to front line therapy had a 2 year survival rate of 55% compared with none for refractory disease (p = 0.029) after salvage therapy. Median survival for the entire group was 17.5 months. Better survival was seen in pts who were asymptomatic with low levels of LDH, previous CR, non high-grade histology, and limited disease stage at relapse. Toxicity was mainly hematologic: 91.5% had neutropenia, (56.5% grade III-IV), and 9.5% died from infectious complications. Other clinical toxicities including cardiac toxicity were negligible. MIZE chemotherapy was effective in patients with relapsed and refractory lymphoma and showed limited clinical and cardiac toxicity. Myelosupression was the most frequent single toxicity.
ISSN:1042-8194
1029-2403
DOI:10.3109/10428199709050895