Abstract
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.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 468-471 |
| Number of pages | 4 |
| Journal | Annals of Oncology |
| Volume | 22 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2 2011 |
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Keywords
- Childhood
- Lymphoma
- Recurrent
- Refractory
ASJC Scopus subject areas
- Hematology
- Oncology
Cite this
Efficacy of high-dose methotrexate, ifosfamide, etoposide and dexamethasone salvage therapy for recurrent or refractory childhood malignant lymphoma. / Sandlund, J. T.; Pui, C. H.; Mahmoud, H.; Zhou, Y.; Lowe, E.; Kaste, S.; Kun, L. E.; Krasin, M. J.; Onciu, M.; Behm, F. G.; Ribeiro, R. C.; Razzouk, B. I.; Howard, S. C.; Metzger, M. L.; Hale, G. A.; Rencher, R.; Graham, K.; Hudson, M. M.
In: Annals of Oncology, Vol. 22, No. 2, 02.02.2011, p. 468-471.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Efficacy of high-dose methotrexate, ifosfamide, etoposide and dexamethasone salvage therapy for recurrent or refractory childhood malignant lymphoma
AU - Sandlund, J. T.
AU - Pui, C. H.
AU - Mahmoud, H.
AU - Zhou, Y.
AU - Lowe, E.
AU - Kaste, S.
AU - Kun, L. E.
AU - Krasin, M. J.
AU - Onciu, M.
AU - Behm, F. G.
AU - Ribeiro, R. C.
AU - Razzouk, B. I.
AU - Howard, S. C.
AU - Metzger, M. L.
AU - Hale, G. A.
AU - Rencher, R.
AU - Graham, K.
AU - Hudson, M. M.
PY - 2011/2/2
Y1 - 2011/2/2
N2 - 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.
AB - 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.
KW - Childhood
KW - Lymphoma
KW - Recurrent
KW - Refractory
UR - http://www.scopus.com/inward/record.url?scp=79251565546&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79251565546&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdq348
DO - 10.1093/annonc/mdq348
M3 - Article
C2 - 20624787
AN - SCOPUS:79251565546
VL - 22
SP - 468
EP - 471
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 2
ER -