Effectiveness of Interferon-Alfa and Mid-Cycle Chemotherapy Added to an Anthracycline-Based Regimen in the Treatment of Aggressive Non-Hodgkin's Lymphoma

Autor:	Mary Beth Riley, Stephanie A. Gregory, Raywin Huang, Ahmad Jajeh, Homayoun Shahidi, Sari H. Enschede, Parameswaran Venugopal, Harvey D. Preisler
Rok vydání:	2001
Předmět:	Adult Male Cancer Research medicine.medical_specialty Vincristine medicine.medical_treatment CHOP Severity of Illness Index Gastroenterology Drug Administration Schedule International Prognostic Index Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Anthracyclines Progression-free survival Aged Aged 80 and over Chemotherapy business.industry Lymphoma Non-Hodgkin Remission Induction Interferon-alpha Hematology Middle Aged medicine.disease Survival Analysis Chemotherapy regimen Non-Hodgkin's lymphoma Surgery Regimen Treatment Outcome Therapeutic Equivalency Oncology Female business medicine.drug
Zdroj:	Leukemia & Lymphoma. 40:325-334
ISSN:	1029-2403 1042-8194
Popis:	Interferon-alfa in combination with cytotoxic chemotherapy has been shown to be effective in treating certain types of non-Hodgkin's lymphoma (NHL) (1). However, there is no published data on upfront induction treatment of aggressive NHL with IFN-alfa containing regimens. Studies have also shown that one can overcome regrowth resistance by administering mid-cycle agents which slow tumor proliferation between courses of cytotoxic therapy (2). Based on this, we treated 32 consecutive patients between 1/93 and 9/96 with a regimen containing cyclophosphamide 750 mg/m2, mitoxantrone 12 mg/m2, and teniposide 60 mg/m2 IV on day 1 with prednisone 100 mg PO given on days 1-5. On day 15, patients received vincristine 1.4 mg/m2 (2 mg max.) and bleomycin 10 units/m2 IV. Interferon-alfa-2b 5x10(6) units/m2 SQ was administered on days 22-26. The median age was 55 (range 26-83), M:F ratio was 2.5:1, and the median International Prognostic Index was 2. 38% of patients had stages I-II and 62% had stages III-IV disease. Fifty-nine percent of the patients achieved a complete response, 22% a partial response, and 19% had progressive disease. The overall survival (OS) was 81% and the progression free survival (PFS) was 56% at 4.3 years. There were no severe (grade IV) hematologic, flu-like, GI and infectious toxicities from IFN-alpha. Leukopenia was the main severe toxicity related to the chemotherapy regimen (days 1-15), but not IFN-alpha. Severe infection secondary to the chemotherapy regimen occurred in one patient. Interferon-alfa-2b and mid-cycle chemotherapy added to an anthracycline based regimen is effective induction treatment for patients with aggressive NHL. The OS and PFS using this regimen, based on regrowth resistance, appears to be at least as or more effective than CHOP therapy for this group of patients. Severe toxicities were rare.
Databáze:	OpenAIRE
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