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  • Title: Etoposide, mitoxantrone and prednisone: a salvage regimen with low toxicity for refractory or relapsed non-Hodgkin's lymphoma.
    Author: Doorduijn JK, Spruit P, van Der Holt B, van't Veer M, Budel L, Löwenberg B, Sonneveld P.
    Journal: Haematologica; 2000 Aug; 85(8):814-9. PubMed ID: 10942927.
    Abstract:
    BACKGROUND AND OBJECTIVES: Relapsed non-Hodgkin's lymphoma (NHL) is preferably treated with high-dose therapy and stem cell support. However, not all patients qualify for intensive chemotherapy. We evaluated the efficacy and toxicity of a new salvage chemotherapy regimen designed for patients with relapsed or refractory NHL who are not appropriate candidates for high-dose therapy (HDT). DESIGN AND METHODS: Seventy-nine patients received a regimen consisting of etoposide (350 mg/m(2) i.v. day 1), mitoxantrone (14 mg/m(2) i.v. day 1) and prednisone (80 mg/m(2) p.o. days 1-5) (EMP). The majority had aggressive NHL. Twenty-one patients were elderly, i.e. >60 years of age; RESULTS: The overall response rate in the 79 patients was 38% as compared to 67% in the elderly. The progression-free survival was 54% and 30% at 12 months and 24 months, respectively. The toxicity of the regimen was relatively low. No toxic deaths have occurred. In 28 of 231 cycles (12%) a CTC-grade 2-4 infection was encountered. Twenty-one hospital admissions were necessary because of infection or fever. Other toxicity was rare. Toxicity was not greater in the elderly patients. WHO performance status 2-4 and elevated serum lactate dehydrogenase (LDH) concentrationv were adverse prognostic factors for response as well as for overall survival. Another adverse prognostic factor for response was age <60 years. INTERPRETATION AND CONCLUSIONS: EMP is a new salvage regimen with a relatively low toxicity. It should be considered for patients with relapsed or refractory NHL who are not candidates for standard reinduction therapy and stem cell transplantation.
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