TY - JOUR
T1 - Mitoxantrone, vinblastine and CCNU
T2 - Long-term follow-up of patients treated for advanced and poor-prognosis Hodgkin's disease
AU - Alexandrescu, Doru T.
AU - Karri, Sirisha
AU - Wiernik, Peter
AU - Dutcher, Janice P.
N1 - Funding Information:
This study was supported in part by Cancer Center Support Grant P30CA13330, awarded by the National Cancer Institute, DHHS; by a Cooperative Agreement for participation in the Eastern Cooperative Oncology Group, 5U10CA14958, awarded to the Albert Einstein College of Medicine by the National Cancer Institute, DHHS; and by a grant from the Immunex Corporation. There was limited participation through patient enrollment 1987 – 2002 by other Eastern Cooperative Oncology Group institutions. Support for patient accrural was provided by the Albert Einstein Cancer Center and Our Lady of Mercy Cancer Center. This study was previously presented in part at the annual meeting of the American Society of Hematology (1993), at the VI International Conference on Malignant Lymphoma (1996) and at the Annual Meeting of the American Society of Hematology 2004 (abstract # 1312, Poster session 466-I). Preliminary results of this study have been published previously [8,11].
PY - 2006/4
Y1 - 2006/4
N2 - Advanced-stage or relapsed/refractory Hodgkin's disease (HD) has a poor prognosis despite aggressive chemotherapy regimens and the use of high-dose therapy with autologous stem cell support. Mitoxantrone, vinblastine and CCNU (lomustine) (MVC) combines the most effective chemotherapeutic agents of previous regimens for poor prognosis HD, and eliminates marginally active agents with unnecessary toxicities, such as bleomycin and dacarbazine. Sixty-eight patients with HD (23 newly diagnosed and 45 with relapsed/refractory disease, one patient treated both de novo and years later in relapse) were treated with the MVC regimen (mitoxantrone 8 mg/m2/day i.v. days 1 - 3; vinblastine 8 m/m2/day days 1 and 22; and CCNU (lomustine) 100 mg/m2 on day 1, repeated at 6-8 weeks) in a single-arm Phase II study. All patients responded to treatment in the newly diagnosed group (overall response = 100%). The median response duration was not reached, but was in the range 7.6-180 + months, and median survival was 94 months. Eleven complete responses are ongoing at 39-180 + months. In the previously-treated patients, 41 responded to MVC (OR = 91%). The median response duration for this group was 11 months, and the median survival was 34 months after initiating MVC. Four secondary myeloid leukemias occurred, three in de novo, and one in the relapsed/ refractory group, at a median follow-up of 14 years. MVC regimen for HD is highly active, for both de novo and relapsed/refractory disease, with high response rates and survival that compare favourably with the results obtained by high-dose therapy with stem-cell transplantation. Although significant, the toxicities associated with this regimen were manageable.
AB - Advanced-stage or relapsed/refractory Hodgkin's disease (HD) has a poor prognosis despite aggressive chemotherapy regimens and the use of high-dose therapy with autologous stem cell support. Mitoxantrone, vinblastine and CCNU (lomustine) (MVC) combines the most effective chemotherapeutic agents of previous regimens for poor prognosis HD, and eliminates marginally active agents with unnecessary toxicities, such as bleomycin and dacarbazine. Sixty-eight patients with HD (23 newly diagnosed and 45 with relapsed/refractory disease, one patient treated both de novo and years later in relapse) were treated with the MVC regimen (mitoxantrone 8 mg/m2/day i.v. days 1 - 3; vinblastine 8 m/m2/day days 1 and 22; and CCNU (lomustine) 100 mg/m2 on day 1, repeated at 6-8 weeks) in a single-arm Phase II study. All patients responded to treatment in the newly diagnosed group (overall response = 100%). The median response duration was not reached, but was in the range 7.6-180 + months, and median survival was 94 months. Eleven complete responses are ongoing at 39-180 + months. In the previously-treated patients, 41 responded to MVC (OR = 91%). The median response duration for this group was 11 months, and the median survival was 34 months after initiating MVC. Four secondary myeloid leukemias occurred, three in de novo, and one in the relapsed/ refractory group, at a median follow-up of 14 years. MVC regimen for HD is highly active, for both de novo and relapsed/refractory disease, with high response rates and survival that compare favourably with the results obtained by high-dose therapy with stem-cell transplantation. Although significant, the toxicities associated with this regimen were manageable.
KW - Advanced stage
KW - CCNU
KW - Hodgkin's disease
KW - MVC
KW - Mitoxantrone
KW - Poor prognosis
KW - Salvage therapy
KW - Vinblastine
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U2 - 10.1080/10428190500376241
DO - 10.1080/10428190500376241
M3 - Article
C2 - 16690523
AN - SCOPUS:33646758228
SN - 1042-8194
VL - 47
SP - 641
EP - 656
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 4
ER -