Ifosfamide and vinorelbine: an active regimen for patients with relapsed or refractory Hodgkin's disease

Bonfante, V.; Viviani, Simonetta; Santoro, Armando; Devizzi, Liliana; Russo, Anna; Zanini, M.; Soncini, F.; Parra, Héctor Soto; Valagussa, Pinuccia; Bonadonna, Gianni

doi:10.1046/j.1365-2141.1998.00989.x

Cited by 44 publications

(26 citation statements)

References 9 publications

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“…The study regimen, which was based on the results of previous protocols including vinorelbine, 26 gemcitabine, 27 and ifosfamide plus vinorelbine, 24,28 induced an overall response rate of 81.3%, which is comparable to rates reported in the past. However, the incidence of complete remission induced by four courses of IGEV, was very high (53.8%) compared with previous data (Table 5).…”

Section: Discussionsupporting

confidence: 64%

“…In November 1997, following initial experiences with single-agent vinorelbine 26 and gemcitabine, 27 as well as with a combination of vinorelbine and ifosfamide, 24,28 we designed a new chemotherapy regimen including gemcitabine, vinorelbine, and ifosfamide for patients with refractory or relapsed Hodgkin's lymphoma. This combination was used in a multicenter study whose results with regards to response rates, toxicity, and stem cell mobilization are reported here.…”

Section: 4-5 13-15mentioning

confidence: 99%

“…Very few studies reported data relating to which standard-dose salvage regimen is the best to induce a good clinical response and shrinkage of bulky disease [16][17][18][19][20][21][22][23][24][25] before high-dose therapy. Hence, the identification of new active regimens, combining therapeutic activity and CD34 + stem cell mobilizing potential, is of the utmost importance to increase pre-transplant response rates and, possibly, the final outcome.…”

Section: 4-5 13-15mentioning

confidence: 99%

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Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin's lymphoma

Santoro¹,

Magagnoli²,

Spina³

et al. 2007

Haematologica

214

140

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Section: Discussionsupporting

confidence: 64%

Section: 4-5 13-15mentioning

confidence: 99%

Section: 4-5 13-15mentioning

confidence: 99%

See 1 more Smart Citation

Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin's lymphoma

Santoro¹,

Magagnoli²,

Spina³

et al. 2007

Haematologica

214

140

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“…[12][13][14][15][16][17][18] Gemcitabine has recently been shown to be active in heavily pretreated HD patients, with a response rate of 40% and a low level of drug-related toxicity. 19 The aim of this study was to determine the efficacy of ifosfamide/vinorelbine-based regimens and G-CSF in PBSC mobilization.…”

mentioning

confidence: 99%

Mobilizing potential of ifosfamide/vinorelbine-based chemotherapy in pretreated malignant lymphoma

Magagnoli

Sarina

Balzarotti

et al. 2001

Bone Marrow Transplant

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Summary:The mobilizing potential and therapeutic activity of ifosfamide/vinorelbine-containing regimens with G-CSF support were explored in patients with pretreated malignant lymphomas. Ten patients with non-Hodgkin's lymphoma (NHL) received ifosfamide and vinorelbine, and 17 with Hodgkin's disease (HD) received ifosfamide, vinorelbine and gemcitabine (IGEV regimen), as induction chemotherapy before high-dose chemotherapy (HDT) with peripheral blood stem cell (PBSC) support. Most of the patients had been heavily pretreated with various chemotherapy regimens ± radiotherapy. The target yield was у3 × 10 6 CD34 + cells/kg of body weight in order to support the subsequent myeloablative chemotherapy. The optimal PBSC harvest occurred on days 11 and 12, with no difference in CD34 Despite the high curability rate of aggressive non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD) with front-line therapy, only a small fraction of patients with refractory or relapsing disease can be successfully managed using standard-dose salvage chemotherapy. The encouraging results of high-dose therapy (HDT) with peripheral blood stem cell (PBSC) support have been widely demonstrated in both diseases.1,2 Over the last few years, PBSCs have come to be preferred over autologous bone marrow because of their ability to shorten the myelosuppressed period, accelerate engraftment of both neutrophils and platelets, and reduce blood product and antibiotic requirements. 3,4 Hematopoietic growth factors with or without high-dose cyclophosphamide are considered standard procedures for adequate mobilization of PBSCs, 5 although other combinations of chemotherapy and growth factors have also been used. A number of studies have demonstrated the superiority of the combination of chemotherapy and growth factors over either element alone, as well as the correlation between the intensity of the chemotherapy with the number of mobilized PBSCs.6-11 The best option is therefore a regimen that embodies both proven mobilizing and adequate antineoplastic activity.The efficacy of ifosfamide and/or vinorelbine-based chemotherapy as salvage regimens for poor prognosis lymphoma has also been demonstrated. [12][13][14][15][16][17][18] Gemcitabine has recently been shown to be active in heavily pretreated HD patients, with a response rate of 40% and a low level of drug-related toxicity.

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“…7,[22][23][24][25] Although a number of phase II studies have shown that high-dose ablative therapy with stem cell transplantation was effective in patients with disease sensitive to pre-transplant salvage therapy, [1][2][3][4][5][6][7]26 patients with resistant lymphoma, particularly those with primary refractory disease, have poor survival rates. 6,7,27,28 In these patients, sensitivity of the tumor may have been reduced to below the 4-log kill with standard dose, which may not allow cure by a three-to five-fold increase in dose in the majority of patients, typically used in stem cell transplantation.…”

Section: Discussionmentioning

confidence: 99%

A dose escalation study for salvage chemotherapy in patients with refractory lymphoma prior to high-dose myeloablative therapy with stem cell transplantation

Lee

Magalhaes-Silverman

Hara

et al. 2002

Bone Marrow Transplant

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Summary:Chemosensitive response prior to transplantation has been shown to be most significant for survival post transplant. To estimate toxicity of a dose-intensive regimen that was to improve chemosensitive response rate, 15 patients with primary refractory lymphoma were enrolled in dose escalation of pre-transplant salvage chemotherapy. The first cycle had a fixed dose of ifosfamide 6 g/m 2 and mitoxantrone 12 mg/m 2 , with arabinosyl cytosine (Ara-C) 2 g/m 2 , and methylprednisolone 2.0 g. Each cycle of the second and third had cisplatin 90 mg/m 2 , Ara-C 6 g/m 2 , methylprednisolone 2.0 g, and escalated doses of ifosfamide from 7.5 g/m 2 to 15 g/m 2 and mitoxantrone from 16 to 28 mg/m 2 . Blood stem cells were collected before the second cycle and у3 ؋ 10 6 CD34 cells/kg were infused 2 days after the second and third cycles, respectively. The maximum tolerated doses of ifosfamide and mitoxantrone were 11.25 g/m 2 and 16 mg/m 2 , respectively. Acute renal failure and bacterial infection occurred as non-hematologic dose limiting toxicities. Eleven patients completed therapy. Five patients achieved complete remission and five had partial remission. Nine patients received autologous and four received allogeneic transplants. Currently, six are alive without evidence of disease, with a 3-year survival of 40%. Although preliminary, the regimen suggests acceptable toxicity and significant activity that warrants further study.

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Ifosfamide and vinorelbine: an active regimen for patients with relapsed or refractory Hodgkin's disease

Cited by 44 publications

References 9 publications

Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin's lymphoma

Ifosfamide, gemcitabine, and vinorelbine: a new induction regimen for refractory and relapsed Hodgkin's lymphoma

Mobilizing potential of ifosfamide/vinorelbine-based chemotherapy in pretreated malignant lymphoma

A dose escalation study for salvage chemotherapy in patients with refractory lymphoma prior to high-dose myeloablative therapy with stem cell transplantation

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