Haematologica, Vol 92, Issue 1, 35-41 doi:10.3324/haematol.10661
Copyright © 2007 by Ferrata Storti Foundation
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Santoro, A.
Right arrow Articles by Balzarotti, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Santoro, A.
Right arrow Articles by Balzarotti, M.
Related Collections
Right arrowRelated Article

Malignant Lymphomas

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

Armando Santoro, Massimo Magagnoli, Michele Spina, Graziella Pinotti, Licia Siracusano, Mariagrazia Michieli, Andrea Nozza, Barbara Sarina, Emanuela Morenghi, Luca Castagna, Umberto Tirelli, Monica Balzarotti

From the Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Italy (AS, MM, LS, AN, BS, EM, LC, MB), Department of Medical Oncology, Centro di Riferimento Oncologico, Aviano, Italy (MS, MM, UT), Division of Medical Oncology, Ospedale di Circolo, Varese, Italy (GP)

Correspondence: Armando Santoro, M.D., Department of Medical Oncology and Hematology, Istituto Clinico Humanitas, via Manzoni 56, 20089 Rozzano, Milan, Italy. E-mail: armando.santoro{at}humanitas.it

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 ≥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.

Key words: Hodgkin’s lymphoma, salvage chemotherapy, complete remission, CD34+ cell mobilization.


Related Article

Treatment of refractory and relapsed Hodgkin's lymphoma: facts and perspectives
Ercole Brusamolino, Angelo Michele Carella
Haematologica 2007 92: 6-10. [Full Text] [PDF]



This article has been cited by other articles:


Home page
Ann OncolHome page
C. Fernandez de Larrea, C. Martinez, A. Gaya, A. Lopez-Guillermo, M. Rovira, F. Fernandez-Aviles, M. Lozano, F. Bosch, J. Esteve, B. Nomdedeu, et al.
Salvage chemotherapy with alternating MINE-ESHAP regimen in relapsed or refractory Hodgkin's lymphoma followed by autologous stem-cell transplantation
Ann. Onc., November 4, 2009; (2009) mdp487v1.
[Abstract] [Full Text] [PDF]


Home page
Ann OncolHome page
A. Engert, D. A. Eichenauer, M. Dreyling, and On behalf of the ESMO Guidelines Working Group
Hodgkin's lymphoma: ESMO Clinical Recommendations for diagnosis, treatment and follow-up
Ann. Onc., May 1, 2009; 20(suppl_4): iv108 - iv109.
[Full Text] [PDF]


Home page
haematolHome page
E. Brusamolino, A. Bacigalupo, G. Barosi, G. Biti, P. G. Gobbi, A. Levis, M. Marchetti, A. Santoro, P. L. Zinzani, and S. Tura
Classical Hodgkin's lymphoma in adults: guidelines of the Italian Society of Hematology, the Italian Society of Experimental Hematology, and the Italian Group for Bone Marrow Transplantation on initial work-up, management, and follow-up
Haematologica, April 1, 2009; 94(4): 550 - 565.
[Abstract] [Full Text] [PDF]


Home page
The OncologistHome page
J. H. Mendler and J. W. Friedberg
Salvage Therapy in Hodgkin's Lymphoma
Oncologist, April 1, 2009; 14(4): 425 - 432.
[Abstract] [Full Text] [PDF]


Home page
haematolHome page
P. Anderlini, R. Saliba, S. Acholonu, S. A. Giralt, B. Andersson, N. T. Ueno, C. Hosing, I. F. Khouri, D. Couriel, M. de Lima, et al.
Fludarabine-melphalan as a preparative regimen for reduced-intensity conditioning allogeneic stem cell transplantation in relapsed and refractory Hodgkin's lymphoma: the updated M.D. Anderson Cancer Center experience
Haematologica, February 1, 2008; 93(2): 257 - 264.
[Abstract] [Full Text] [PDF]


Home page
haematolHome page
E. Brusamolino and A. M. Carella
Treatment of refractory and relapsed Hodgkin's lymphoma: facts and perspectives
Haematologica, January 1, 2007; 92(1): 6 - 10.
[Full Text] [PDF]