Ifosfamide combinations in lymphoma.

From 1977 to 1989, combination ifosfamide and etoposide has been used at the M.D. Anderson Cancer Center for management of lymphoma in both untreated patients and patients with recurrent disease. Results of the various salvage regimens are reviewed. On the average, overall and complete response rates have been 60% and 25%, respectively. Median survival time was 9 months for relapsed intermediate-grade lymphoma and 12 months for low-grade lymphoma. The preliminary results of a new combination, mesna, ifosfamide, novantrone, etoposide (MINE), are discussed. Finally, we discuss the long-term results (at 10 years of follow-up) of a front-line protocol using ifosfamide/methotrexate/etoposide (IMVP-16) as consolidation or intensification for cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) responders. At 10 years, 62% of intermediate-grade lymphoma patients are alive and disease free.