BACKGROUND: Children with recurrent or refractory malignant lymphoma generally have a poor prognosis. There is a need for new active drug combinations for this high-risk group of patients. PATIENTS AND METHODS: This study evaluated the activity and toxicity of the methotrexate, ifosfamide, etoposide and dexamethasone (MIED) regimen for childhood refractory/recurrent non-Hodgkin's lymphoma (NHL) or Hodgkin's lymphoma (HL). From 1991 through 2006, 62 children with refractory/recurrent NHL (n = 24) or HL (n = 38) received one to six cycles of MIED. Based on MIED response, intensification with hematopoietic stem cell transplantation (HSCT) was considered. RESULTS: There were 10 complete (CR) and 5 partial responses (PR) among the 24 children with NHL [combined response rate, 63%; 95% confidence interval (CI) 38% to 73%]. There were 13 CR and 18 PR among the 37 assessable children with HL (combined response rate, 84%; 95% CI, 68% to 94%). Although 59% courses were associated with grade IV neutropenia, treatment was well tolerated and without toxic deaths. CONCLUSIONS: MIED is an effective regimen for refractory/recurrent childhood malignant lymphoma, permitting a bridge to intensification therapy with HSCT.
BACKGROUND:Children with recurrent or refractory malignant lymphoma generally have a poor prognosis. There is a need for new active drug combinations for this high-risk group of patients. PATIENTS AND METHODS: This study evaluated the activity and toxicity of the methotrexate, ifosfamide, etoposide and dexamethasone (MIED) regimen for childhood refractory/recurrent non-Hodgkin's lymphoma (NHL) or Hodgkin's lymphoma (HL). From 1991 through 2006, 62 children with refractory/recurrent NHL (n = 24) or HL (n = 38) received one to six cycles of MIED. Based on MIED response, intensification with hematopoietic stem cell transplantation (HSCT) was considered. RESULTS: There were 10 complete (CR) and 5 partial responses (PR) among the 24 children with NHL [combined response rate, 63%; 95% confidence interval (CI) 38% to 73%]. There were 13 CR and 18 PR among the 37 assessable children with HL (combined response rate, 84%; 95% CI, 68% to 94%). Although 59% courses were associated with grade IV neutropenia, treatment was well tolerated and without toxic deaths. CONCLUSIONS:MIED is an effective regimen for refractory/recurrent childhood malignant lymphoma, permitting a bridge to intensification therapy with HSCT.
Authors: C H Moskowitz; S D Nimer; A D Zelenetz; T Trippett; E E Hedrick; D A Filippa; D Louie; M Gonzales; J Walits; N Coady-Lyons; J Qin; R Frank; J R Bertino; A Goy; A Noy; J P O'Brien; D Straus; C S Portlock; J Yahalom Journal: Blood Date: 2001-02-01 Impact factor: 22.113
Authors: A Reiter; M Schrappe; M Tiemann; W D Ludwig; E Yakisan; M Zimmermann; G Mann; A Chott; W Ebell; T Klingebiel; N Graf; B Kremens; S Müller-Weihrich; H J Plüss; F Zintl; G Henze; H Riehm Journal: Blood Date: 1999-11-15 Impact factor: 22.113
Authors: Catherine Patte; Anne Auperin; Mary Gerrard; Jean Michon; Ross Pinkerton; Richard Sposto; Claire Weston; Martine Raphael; Sherrie L Perkins; Keith McCarthy; Mitchell S Cairo Journal: Blood Date: 2007-04-01 Impact factor: 22.113
Authors: K Seidemann; M Tiemann; M Schrappe; E Yakisan; I Simonitsch; G Janka-Schaub; W Dörffel; M Zimmermann; G Mann; H Gadner; R Parwaresch; H Riehm; A Reiter Journal: Blood Date: 2001-06-15 Impact factor: 22.113
Authors: N L Kobrinsky; R Sposto; N R Shah; J R Anderson; C DeLaat; M Morse; P Warkentin; G S Gilchrist; M D Cohen; D Shina; A T Meadows Journal: J Clin Oncol Date: 2001-05-01 Impact factor: 44.544
Authors: L Brugières; P Quartier; M C Le Deley; H Pacquement; Y Perel; C Bergeron; C Schmitt; J Landmann; C Patte; M J Terrier-Lacombe; G Delsol; O Hartmann Journal: Ann Oncol Date: 2000-01 Impact factor: 32.976
Authors: J T Sandlund; C H Pui; V M Santana; H Mahmoud; W M Roberts; S Morris; S Raimondi; R Ribeiro; W M Crist; J S Lin Journal: J Clin Oncol Date: 1994-05 Impact factor: 44.544
Authors: B G Gordon; P I Warkentin; D D Weisenburger; J M Vose; W G Sanger; S E Strandjord; J R Anderson; J D Verdirame; P J Bierman; J O Armitage Journal: Blood Date: 1992-12-01 Impact factor: 22.113