High-dose ifosfamide and mitoxantrone (HDIM) in patients with relapsed or refractory Hodgkin's lymphoma

Scientific paper - Original scientific paper

• Author: Igor Aurer
• Author: Damir Nemet
• Author: Zdravko Mitrović
• Author: Dino Dujmović
• Author: Sandra Bašić-Kinda
• Author: Ivo Radman
• Author: Dubravka Sertić
• Author: Fedor Šantek
• Author: Marko Kralik
• Author: Snježana Dotlić
• Author: Sanja Mazić
• Author: Boris Labar
• Author's institution: University of Zagreb; School of Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences

Abstract (english)

Relapsed/refractory Hodgkin's lymphoma (HL) is treated with salvage chemotherapy and autologous stem cell transplantation (ASCT). Optimal chemotherapy is unknown. We retrospectively analyzed outcomes of 58 patients treated with 2 cycles of high-dose ifosfamide and mitoxantrone (HDIM). HDIM consisted of ifosfamide 5 g/m(2)/day and MESNA 5 g/m(2)/day in continuous 24-h infusion (days 1 and 2), MESNA 2.5 g/m(2) over 12 h (day 3), and mitoxantrone 20 mg/m(2) (day 1) administered every 2 weeks. Stem cells were collected after the first cycle. Responding patients proceeded to ASCT. Toxicity was acceptable. Stem cell mobilization was successful in 96 % of patients. Overall response rate was 74 % (89 % in relapsing and 45 % in refractory patients) with 31 % complete remissions. After a median follow-up of 54 months, 5-year event-free survival was 56 % (69 % for relapsing and 35 % for refractory patients), and 5-year overall survival was 67 % (73 % for relapsing and 55 % for refractory patients). Significant adverse prognostic factors were refractoriness to previous therapy and HDIM failure. No differences in outcomes were noted between patients with early and late relapses or between complete and partial responders. HDIM is a well-tolerated and effective regimen for relapsed and refractory HL with excellent stem cell mobilizing properties. Patients failing HDIM may still benefit from other salvage options.

• Keywords (english): Adolescent; Adult; Antineoplastic Combined Chemotherapy Protocols/administration & dosage; Combined Modality Therapy/methods; Female; Follow-Up Studies; Hematopoietic Stem Cell Transplantation/methods; Hodgkin Disease/diagnosis; Hodgkin Disease/therapy; Humans; Ifosfamide/administration & dosage; Male; Middle Aged; Mitoxantrone/administration & dosage; Neoplasm Recurrence, Local/diagnosis; Neoplasm Recurrence, Local/therapy; Retrospective Studies; Transplantation, Autologous; Young Adult
• Language: english
• Publication type: Scientific paper - Original scientific paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Annals of Hematology
• Numbering: vol. 95, no. 7, pp. 1129-1136
• p-ISSN: 0939-5555
• DOI: https://doi.org/10.1007/s00277-016-2676-0
• URN:NBN: urn:nbn:hr:105:978993
• Publication: 2016-06
• Document URL: https://doi.org/10.1007/s00277-016-2676-0
• Type of resource: Text
• Access conditions: Open access
• Created on: 2024-03-28 08:52:21