• Pier Luigi Zinzani, Monica Tani, Anna Lia Molinari, Vittorio Stefoni, Eliana Zuffa, Lapo Alinari, Annalisa Gabriele, Francesca Bonifazi, Marzia Salvucci, Sante Tura, and Michele Baccarani.
• Istituto di Ematologia e Oncologia Medica L. e A. Seràgnoli, Policlinico S.Orsola, via Massarenti 9, 40138 Bologna, Italy. plzinzo@med.unibo.it
• Haematologica. 2002 Aug 1; 87 (8): 816-21.

Background And ObjectivesTherapy for relapsed/refractory lymphomas should be based only on drugs not included in the front-line chemotherapy regimens. We adopted the strategy of using salvage chemotherapy to debulk disease and simultaneously mobilize stem cells, using a regimen based on ifosfamide and etoposide, (drugs not usually used for front-line treatment).Design And MethodsA three-drug combination of ifosfamide, epirubicin and etoposide (IEV) was used to treat 62 patients with relapsing or refractory aggressive non-Hodgkin's lymphoma (NHL; n=51) or Hodgkin's disease (HD; n=11). Forty-five of the patients were studied for the feasibility of peripheral blood stem cell (PBSC) harvest.ResultsThe overall and complete response (CR) rates were, respectively, 77% and 32% in the NHL subset and 81% and 45% in the HD subset. Among the 17 patients who achieved CR after IEV but did not have a subsequent transplantation, the median duration of the response was 9 months (range, 2 to 14 months). Mobilization was successful in 33 of 45 (71%) patients. Among the 45 who proceeded to autotransplantation, 27 (60%) were in CR status after the autograft; 23/45 (51%) patients are currently in continuous CR with a median follow-up of 25 months (range, 10-68 months); the relapse-free survival curve shows 83% in this state at 60 months. Twenty-three (37%) patients are currently in continuous CR with a median follow-up of 25 months. Clinical and hematologic toxic effects were mild.Interpretation And ConclusionsOur results indicate the efficacy of the IEV regimen in inducing a good remission rate. IEV is a predictable and highly effective mobilization regimen in relapsed/refractory patients with aggressive NHL or HD.

33 keywords...

hide…