BACKGROUND AND OBJECTIVES: The prognosis in patients with primary refractory or relapsed high grade non-Hodgkin's lymphoma (NHL) is very poor--the 5-year survival being generally reported at 10%. DESIGN AND METHODS: Multiple salvage regimens have been investigated and, while response rates of 50-80% have been noted in selected patients, the long-term prognosis remains poor. Following the encouraging results in high risk Burkitt's and Burkitt-like lymphoma using the CODOX-M and IVAC protocols, we performed a pilot study using a similar regimen in patients with primary refractory or relapsed high grade NHL. RESULTS: The regimens were modified by a reduction in the intensity of intrathecal therapy. It was planned to mobilize peripheral blood stem cells following the IVAC cycle for use in subsequent autologous peripheral blood stem cell transplantation in chemosensitive patients. The initial plan was to recruit 50 patients, but the study was closed after 8 due to excessive toxicity. INTERPRETATION AND CONCLUSIONS: We conclude that the CODOX-M/IVAC regimen is too toxic for this group of patients and does not result in better response rates than those to currently available salvage regimens.
BACKGROUND AND OBJECTIVES: The prognosis in patients with primary refractory or relapsed high grade non-Hodgkin's lymphoma (NHL) is very poor--the 5-year survival being generally reported at 10%. DESIGN AND METHODS: Multiple salvage regimens have been investigated and, while response rates of 50-80% have been noted in selected patients, the long-term prognosis remains poor. Following the encouraging results in high risk Burkitt's and Burkitt-like lymphoma using the CODOX-M and IVAC protocols, we performed a pilot study using a similar regimen in patients with primary refractory or relapsed high grade NHL. RESULTS: The regimens were modified by a reduction in the intensity of intrathecal therapy. It was planned to mobilize peripheral blood stem cells following the IVAC cycle for use in subsequent autologous peripheral blood stem cell transplantation in chemosensitive patients. The initial plan was to recruit 50 patients, but the study was closed after 8 due to excessive toxicity. INTERPRETATION AND CONCLUSIONS: We conclude that the CODOX-M/IVAC regimen is too toxic for this group of patients and does not result in better response rates than those to currently available salvage regimens.
Authors: Ewa Paszkiewicz-Kozik; Wojciech Michalski; Michał Taszner; Monika Mordak-Domagała; Joanna Romejko-Jarosińska; Wanda Knopińska-Posłuszny; Jacek Najda; Anna Borawska; Monika Chełstowska; Monika Świerkowska; Anna Dąbrowska-Iwanicka; Agata Malenda; Agnieszka Druzd-Sitek; Robert Konecki; Beata Kumiega; Michał Osowiecki; Beata Ostrowska; Tomasz Szpila; Marcin Szymański; Łukasz Targoński; Katarzyna Domańska-Czyż; Lidia Popławska; Sebastian Giebel; Andrzej Lange; Andrzej Pluta; Jan Maciej Zaucha; Grzegorz Rymkiewicz; Jan Walewski Journal: Br J Haematol Date: 2022-04-01 Impact factor: 8.615