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Sequential high-dose ifosfamide, carboplatin and etoposide with rituximab for relapsed Hodgkin and large B-cell non-Hodgkin lymphoma: increased toxicity without improvement in progression-free survival.

Publication ,  Journal Article
Shea, TC; Beaven, AW; Moore, DT; Serody, JS; Gabriel, DA; Chao, N; Gockerman, JP; Garcia, RA; Rizzieri, DA
Published in: Leuk Lymphoma
May 2009

Non-cross resistant drugs given at high-dose intensity may maximise tumor cell kill leading to improved patient outcomes. We investigated the feasibility and efficacy of administering ifosfamide, carboplatin and etoposide +/- rituximab as sequential high-dose single agents. Twenty-two patients with relapsed/refractory Hodgkin lymphoma (n = 9) or non-Hodgkin (n = 13) lymphoma (NHL) were included. Therapy included: cycle 1 ifosfamide (15 g/m(2)), cycle 2 etoposide (900 mg/m(2)) and cycle 3 carboplatin (area under the curve 15). Patients with NHL received rituximab (375 mg/m(2)) with cycles 1 and 2. Blood stem cell collection was performed after etoposide. Primary endpoints were overall response (complete response (CR) + PR) and ability to mobilise stem cells after etoposide. Secondary endpoints were to assess the toxicity of the regimen and to evaluate the ability of patients to proceed to stem cell transplant (SCT). Overall response rate was 54% with CR in 4/22 (18%) subjects and PR in 8/22 (36%). Median progression-free survival was 15 months and overall survival has not been reached at 40 months. Thirteen participants proceeded to SCT. Grade 3/4 thrombocytopenia and neutropenia occurred in 58% of cycles and 91% of subjects respectively. Forty-five percent of patients required hospitalisation for toxicity and two patients died from complications of therapy. Sequential dose intense ifosfamide, etoposide, carboplatin +/- rituximab was more toxic and no more effective than the same drugs given in a conventional fashion.

Duke Scholars

Published In

Leuk Lymphoma

DOI

EISSN

1029-2403

Publication Date

May 2009

Volume

50

Issue

5

Start / End Page

741 / 748

Location

United States

Related Subject Headings

  • Young Adult
  • Transplantation, Autologous
  • Thrombocytopenia
  • Survival Analysis
  • Salvage Therapy
  • Remission Induction
  • Peripheral Blood Stem Cell Transplantation
  • Neutropenia
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Shea, T. C., Beaven, A. W., Moore, D. T., Serody, J. S., Gabriel, D. A., Chao, N., … Rizzieri, D. A. (2009). Sequential high-dose ifosfamide, carboplatin and etoposide with rituximab for relapsed Hodgkin and large B-cell non-Hodgkin lymphoma: increased toxicity without improvement in progression-free survival. Leuk Lymphoma, 50(5), 741–748. https://doi.org/10.1080/10428190902853136
Shea, Thomas C., Anne W. Beaven, Dominic T. Moore, Jonathan S. Serody, Don A. Gabriel, Nelson Chao, Jon P. Gockerman, Reynaldo A. Garcia, and David A. Rizzieri. “Sequential high-dose ifosfamide, carboplatin and etoposide with rituximab for relapsed Hodgkin and large B-cell non-Hodgkin lymphoma: increased toxicity without improvement in progression-free survival.Leuk Lymphoma 50, no. 5 (May 2009): 741–48. https://doi.org/10.1080/10428190902853136.
Shea TC, Beaven AW, Moore DT, Serody JS, Gabriel DA, Chao N, Gockerman JP, Garcia RA, Rizzieri DA. Sequential high-dose ifosfamide, carboplatin and etoposide with rituximab for relapsed Hodgkin and large B-cell non-Hodgkin lymphoma: increased toxicity without improvement in progression-free survival. Leuk Lymphoma. 2009 May;50(5):741–748.

Published In

Leuk Lymphoma

DOI

EISSN

1029-2403

Publication Date

May 2009

Volume

50

Issue

5

Start / End Page

741 / 748

Location

United States

Related Subject Headings

  • Young Adult
  • Transplantation, Autologous
  • Thrombocytopenia
  • Survival Analysis
  • Salvage Therapy
  • Remission Induction
  • Peripheral Blood Stem Cell Transplantation
  • Neutropenia
  • Middle Aged
  • Male