IMVP-16/Pd (Ifosfamide/Methotrexate/VP-16/Prednisone) Combination Chemotherapy for the Treatment of Relapsed or Refractory Non-Hodgkin's Lymphoma.
- Author:
Ki Hyeong LEE
1
;
Young Iee PARK
;
Heung Moon CHANG
;
Tae You KIM
;
Keong Hae JUNG
;
In Suk WOO
;
Young Hyuck IM
;
Dae Seog HEO
;
Yung Jue BANG
;
Seonyang PARK
;
Byoung Kook KIM
;
Noe Kyeong KIM
Author Information
1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
IMVP-16/Pd;
non-Hodgkin's lymphoma
- MeSH:
Drug Therapy, Combination*;
Drug-Induced Liver Injury;
Etoposide;
Follow-Up Studies;
Hemorrhage;
Humans;
Ifosfamide;
Lymphoma, Non-Hodgkin*;
Methotrexate;
Peripheral Nervous System Diseases;
Prednisone;
Sepsis;
Stomatitis
- From:Journal of the Korean Cancer Association
1997;29(3):486-494
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: IMVP-16 (Ifosfamide/Methotrexate/VP-16) regimen consists of drugs that are not commonly used as the first-line therapy of non-Hodgkin's lymphoma. This study was performed to determine the efficacy of this relatively non-cross resistant regimen, with the addition of prednisone, in patients with primary refractory or relapsed non-Hodgkin's lymphoma. MATERIALS AND METHODS: Patients with primary refractory or relpased intermediate to high grade non-Hodgkin's lymphoma were treated with ifosfamide (1000 mg/m2 iv, D1-5 with mesna), methotrexate (30 mg/m2 iv, D 3 & 10), VP-16 (100 mg/m2 iv, D 1-3), and prednisone (120 mg devided by 3 doses, D1-5). The treatment was repeated every 3 weeks. RESULTS: Between Jan. 1988 and Aug. 1993, thirty eight patients were included. In 33 evaluable patients (4 loss-to follow up and 1 ineligibility) the median age was 49 years. The common histologic types were diffuse large cell type (52%) and immunoblastic type (18%). The proportion of patients with relapsed and refractory NHL was 39% and 61%, respectively. The rate of complete remission was 21% (7/33) and overall response rate was 48% (16/33). The median-response duration was 8 months (1.5~45+). Hematologic toxicities were tolerable. Non-hematologic side effects were also tolerable including stomatitis, peripheral neuropathy, and toxic hepatitis. Three treatment-related deaths were associated with sepsis, ARDS (adult respiratory distress syndrome) and acute gastrointestinal bleeding. CONCLUSION: Based on these results, IMVP-16/Pd combination chemotherapy seems to have a moderate efficacy for the relapsed or refractory non-Hodgkin's lymphoma with tolerable toxicities.
