Abstract | PURPOSE: PATIENTS AND METHODS: Twenty-five adults with pretreated advanced-stage low-grade NHL were treated with three-day courses of fludarabine 25 mg/m2/day, cyclophosphamide 350 mg/m2/day, and dexamethasone 20 mg/day, every four weeks for a maximum of six courses. RESULTS: Of the 25 patients, 18 (72%) responded, 8 (32%) achieving CR and 10 (40%) PR. Seven were failures. The median follow-up was 21 months (5-26). Eight CR patients remain in CR after 5-21 months. Of 10 PR patients, 3 are in continuous PR without further treatment after 12, 17 and 18 months. Myelosuppression was the most prevalent toxic effect. Although severe granulocytopenia (granulocyte count nadir < 500/microliter) and thrombocytopenia (platelet count nadir < 50,000/microliter) occurred in only 10% and 16% of courses, respectively, slow granulocyte or platelet count recovery caused delay of 40% of the courses. Nine patients (36%) required discontinuation of therapy because of persistent granulocytopenia and/or thrombocytopenia: three after one course, three after 2-4 courses, and three after five courses. Thirteen infectious episodes in 11 patients complicated 11% of courses. Two of 10 patients monitored for the circulating EBV load showed increased viral load. One of these developed aggressive lymphoma. CD4+ lymphocytes declined from a pre- therapy median value of 425/microliter to 141/microliter post-treatment (P = 0.001). Non-hematologic toxicities were rare and mild. CONCLUSIONS:
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Authors | M Lazzarino, E Orlandi, M Montillo, A Tedeschi, G Pagnucco, C Astori, A Corso, E Brusamolino, L Simoncini, E Morra, C Bernasconi |
Journal | Annals of oncology : official journal of the European Society for Medical Oncology
(Ann Oncol)
Vol. 10
Issue 1
Pg. 59-64
(Jan 1999)
ISSN: 0923-7534 [Print] England |
PMID | 10076723
(Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)
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Chemical References |
- Antineoplastic Agents, Alkylating
- Antineoplastic Agents, Hormonal
- Dexamethasone
- Cyclophosphamide
- Vidarabine
- fludarabine
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Topics |
- Adult
- Aged
- Antineoplastic Agents, Alkylating
(administration & dosage)
- Antineoplastic Agents, Hormonal
(administration & dosage)
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Biopsy
- CD4 Lymphocyte Count
(drug effects)
- Cyclophosphamide
(administration & dosage)
- Dexamethasone
(administration & dosage)
- Disease-Free Survival
- Female
- Humans
- Lymph Nodes
(pathology)
- Lymphoma, Non-Hodgkin
(drug therapy, mortality, pathology)
- Male
- Middle Aged
- Prognosis
- Remission Induction
- Survival Rate
- Treatment Outcome
- Vidarabine
(administration & dosage, analogs & derivatives)
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