Journal of Clinical Oncology, Vol 13, 1734-1741, Copyright © 1995 by American Society of Clinical Oncology
Results of a salvage treatment program for relapsing lymphoma: MINE consolidated with ESHAP
MA Rodriguez, FC Cabanillas, W Velasquez, FB Hagemeister, P McLaughlin, F Swan and JE Romaguera
Department of Hematology, M.D. Anderson Cancer Center, Houston, TX 77030, USA.
PURPOSE: We report the results of a prospective trial in which patients
with relapsing non-Hodgkin's lymphomas were sequentially treated with two
regimens (mesna, ifosfamide, mitoxantrone, and etoposide [MINE], and
etoposide, methylprednisolone, cytarabine, and cisplatin [ESHAP]) if they
had no history of disease resistance to these drugs. PATIENTS AND METHODS:
Ninety-two patients received MINE (mesna 4 g/m2, ifosfamide 4 g/m2,
mitoxantrone 8 mg/m2, and etoposide 195 mg/m2) for a maximum of six courses
followed by ESHAP (etoposide 240 mg/m2, methylprednisone 500 mg/d,
high-dose cytarabine 2 g/m2, and cisplatin 100 mg/m2) for three courses to
consolidate complete response (CR) or for a maximum of six cycles after a
partial response (PR) or no response to MINE. Pretreatment serum levels of
lactate dehydrogenase (LDH) and beta 2-microglobulin (beta 2M) were
documented in 80 of 92 patients. RESULTS: The response rate to MINE-ESHAP
was 69% (48% CRs and 21% PRs), with a median survival time of 24 months and
median time to treatment failure of 12 months. The median time to treatment
failure according to histology was as follows: low-grade histologies, 16
months; low-grade transformed to intermediate-grade, 8 months; and
intermediate-grade, 5 months. The most serious complication was
myelosuppression, which resulted in two deaths due to neutropenic sepsis. A
risk factor model based on beta 2M and LDH levels before salvage treatment
showed three categories of risk, with 36-month survival rates as follows:
low (beta 2M < 3 mg/dL and LDH normal), 61%; intermediate (beta 2M >
or = 3 mg/dL or LDH above normal), 23%; and high (beta 2M > or = 3 mg/dL
and LDH above normal), 0%. CONCLUSION: MINE-ESHAP is an effective salvage
strategy for patients with recurrent lymphoma. Toxicity was acceptable.
Factors that determine prognostic categories at relapse merit further
study.
 CiteULike  Complore  Connotea  Del.icio.us  Digg  Facebook  Reddit  Technorati  Twitter What's this?
This article has been cited by other articles:
|
|
|
|
 
C. Fernandez de Larrea, C. Martinez, A. Gaya, A. Lopez-Guillermo, M. Rovira, F. Fernandez-Aviles, M. Lozano, F. Bosch, J. Esteve, B. Nomdedeu, et al.
Salvage chemotherapy with alternating MINE-ESHAP regimen in relapsed or refractory Hodgkin's lymphoma followed by autologous stem-cell transplantation
Ann. Onc.,
November 4, 2009;
(2009)
mdp487v1.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Numbenjapon, J. Wang, D. Colcher, T. Schluep, M. E. Davis, J. Duringer, L. Kretzner, Y. Yen, S. J. Forman, and A. Raubitschek
Preclinical Results of Camptothecin-Polymer Conjugate (IT-101) in Multiple Human Lymphoma Xenograft Models
Clin. Cancer Res.,
July 1, 2009;
15(13):
4365 - 4373.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. A. Hamlin, A. D. Zelenetz, T. Kewalramani, J. Qin, J. M. Satagopan, D. Verbel, A. Noy, C. S. Portlock, D. J. Straus, J. Yahalom, et al.
Age-adjusted International Prognostic Index predicts autologous stem cell transplantation outcome for patients with relapsed or primary refractory diffuse large B-cell lymphoma
Blood,
September 15, 2003;
102(6):
1989 - 1996.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Coiffier, C. Haioun, N. Ketterer, A. Engert, H. Tilly, D. Ma, P. Johnson, A. Lister, M. F. Buske, J.A. Radford, et al.
Rituximab (Anti-CD20 Monoclonal Antibody) for the Treatment of Patients With Relapsing or Refractory Aggressive Lymphoma: A Multicenter Phase II Study
Blood,
September 15, 1998;
92(6):
1927 - 1932.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
