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

Aurer, Igor and Nemet, Damir and Mitrović, Zdravko and Dujmović, Dino and Bašić-Kinda, Sandra and Radman, Ivo and Sertić, Dubravka and Šantek, Fedor and Kralik, Marko and Dotlić, Snježana and Mazić, Sanja and Labar, Boris (2016) High-dose ifosfamide and mitoxantrone (HDIM) in patients with relapsed or refractory Hodgkin's lymphoma. Annals of Hematology, 95 (7). pp. 1129-36. ISSN 0939-5555

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Abstract

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.

Item Type: Article
MeSH: 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
Departments: Katedra za internu medicinu
Katedra za patologiju
Katedra za radiologiju i opću kliničku onkologiju
Depositing User: Martina Žužak
Status: Published
Creators:
CreatorsEmail
Aurer, IgorUNSPECIFIED
Nemet, DamirUNSPECIFIED
Mitrović, ZdravkoUNSPECIFIED
Dujmović, DinoUNSPECIFIED
Bašić-Kinda, SandraUNSPECIFIED
Radman, IvoUNSPECIFIED
Sertić, DubravkaUNSPECIFIED
Šantek, FedorUNSPECIFIED
Kralik, MarkoUNSPECIFIED
Dotlić, SnježanaUNSPECIFIED
Mazić, SanjaUNSPECIFIED
Labar, BorisUNSPECIFIED
Date: June 2016
Date Deposited: 25 Oct 2017 07:33
Last Modified: 25 Oct 2017 07:33
Subjects: UNSPECIFIED
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2716

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