Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin's lymphoma.

Abstract

BACKGROUND AND OBJECTIVES:

Response to pre-transplant salvage chemotherapy remains the most important prognostic factor for outcome in refractory or relapsed Hodgkin's lymphoma. Results of a new induction regimen are reported in terms of response rates, toxicity, and stem cell mobilization.

DESIGN AND METHODS:

Ninety-one patients with refractory or relapsed Hodgkin's lymphoma were treated prospectively with a salvage regimen consisting of ifosfamide 2000 mg/m2 on days 1 to 4, gemcitabine 800 mg/m2 on days 1 and 4, vinorelbine 20 mg/m2 on day 1, and prednisolone 100 mg on days 1 to 4 (IGEV).

RESULTS:

Forty-nine patients (53.8%) achieved a complete remission and 25 (27.5%) a partial response for an overall response rate of 81.3%. In the multivariate analysis response to the last chemotherapy (p<0.0001) and involvement of > or =3 sites (p<0.049) were the most important prognostic factors for response. Adequate CD34+ cell collection was achieved in 78 out of 79 (98.7%) mobilized patients. So far, no treatment-related death has been documented. Thirteen (4.2%) and 27 (8.6%) out of 313 evaluated cycles had to be delayed or reduced, respectively, mainly because of neutropenia and thrombocytopenia. No grade 4 non-hematologic toxicity was observed, except for one episode of mucositis.

INTERPRETATION AND CONCLUSIONS:

The high response rate, in particular the complete remission rate, the low toxicity profile, and the very high mobilizing potential of the IGEV regimen strongly suggest that patients with relapsed/refractory Hodgkin's lymphoma may benefit from the use of this salvage induction regimen.

• Authors: Armando Santoro, Massimo Magagnoli, Michele Spina, Graziella Pinotti, Licia Siracusano, Mariagrazia Michieli, Andrea Nozza, Barbara Sarina, Emanuela Morenghi, Luca Castagna, Umberto Tirelli, Monica Balzarotti
• Journal: Haematologica (Haematologica) Vol. 92 Issue 1 Pg. 35-41 (Jan 2007) ISSN: 1592-8721 [Electronic] Italy
• PMID: 17229633 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antigens, CD34
• Deoxycytidine
• Vinblastine
• Vinorelbine
• Ifosfamide
• Gemcitabine

Topics

• Adolescent
• Adult
• Antigens, CD34 (biosynthesis)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Deoxycytidine (administration & dosage, analogs & derivatives)
• Female
• Hodgkin Disease (drug therapy)
• Humans
• Ifosfamide (administration & dosage)
• Male
• Middle Aged
• Recurrence
• Stem Cell Transplantation
• Treatment Outcome
• Vinblastine (administration & dosage, analogs & derivatives)
• Vinorelbine
• Gemcitabine