Combination of Fludarabine and Mitoxantrone in Untreated Stages III and IV Low-Grade Lymphoma: S9501
| Autor: | C. Harris Spiridonidis, Keith S. Lanier, Danika Lew, Shaker R. Dakhil, Richard I. Fisher, Thomas M. Grogan, Robert A. Chapman, Stanley P. Balcerzak, William S. Velasquez, Thomas P. Miller |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty medicine.drug_class medicine.medical_treatment Gastroenterology Antimetabolite Disease-Free Survival International Prognostic Index Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Objective response Aged Neoplasm Staging Aged 80 and over Chemotherapy Mitoxantrone business.industry Lymphoma Non-Hodgkin Low grade lymphoma Middle Aged medicine.disease Survival Analysis United States Lymphoma Fludarabine Surgery Treatment Outcome Oncology Female business Vidarabine medicine.drug |
| Zdroj: | Journal of Clinical Oncology. 21:1996-2003 |
| ISSN: | 1527-7755 0732-183X |
| Popis: | Purpose: To determine the efficacy of combination fludarabine and mitoxantrone (FN) in untreated stages III and IV low-grade lymphoma. The major end point was to estimate progression-free survival (PFS) in all eligible patients. Patients and Methods: Seventy-eight eligible patients were registered. Chemotherapy courses were administered every 4 weeks with mitoxantrone 10 mg/m2 on day 1 and fludarabine 25 mg/m2 on days 1, 2, and 3 for a total of six to eight cycles. Pneumocystis carinii prophylaxis was required. Results: Seventy-three patients (94%) attained an objective response. Complete remission was demonstrated in 34 patients (44%) and partial remission was demonstrated in 39 patients (50%). With a median follow-up time of 5.5 years, the median PFS was 32 months, with a 4-year PFS rate of 38%. Median survival has not been reached and 88% of all patients are alive at 4 years. The application of the International Prognostic Index and serologic staging showed significant differences in PFS in all risk groups, whereas overall survival was markedly worse for the highest-risk group in either prognostic model. Three prior Southwest Oncology Group trials using a regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone or a combination of prednisone, vincristine, methotrexate, cytarabine, cyclophosphamide, etoposide, nitrogen mustard, vincristine, procarbazine, and prednisone in similar patient populations demonstrated comparable clinical outcome, although the 4-year survival for FN was better. FN was well tolerated, but mild to severe reversible myelosuppression was noted. Other complications were rare. Conclusion: FN is an effective, safe chemotherapy combination for patients with advanced-stage, low-grade lymphoma. Clinical outcomes were comparable to prior published data using anthracycline-based regimens. |
| Databáze: | OpenAIRE |
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