Efficacy of high-dose methotrexate, ifosfamide, etoposide and dexamethasone salvage therapy for recurrent or refractory childhood malignant lymphoma.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
John T SandlundMelissa M Hudson

Abstract

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. 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. 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. MIED is an effective regimen for refractory/recurrent childhood malignant lymphoma, permitting a bridge to intensification therapy with HSCT.

References

May 1, 1994·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J T SandlundJ S Lin
May 9, 1996·The New England Journal of Medicine·J T SandlundW M Crist
Feb 26, 2000·Annals of Oncology : Official Journal of the European Society for Medical Oncology·L BrugièresO Hartmann
Sep 2, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Günther SchellongUNKNOWN DAL/GPOH

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Citations

Feb 8, 2014·Pediatric Blood & Cancer·Paul D Harker-MurrayPeter David Cole
Mar 17, 2015·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Miguel-Angel PeralesPaul A Carpenter
Oct 14, 2016·Pediatric Blood & Cancer·Anirban DasDeepak Bansal

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