OBJECTIVETo explore the clinical efficacy and safety of lenalidomide plus low dose dexamethasone for treating patients with multiple myeloma (MM).

METHODSA total of 19 MM patients were enrolled to receive the therapeutic schedule of lenalidomide plus dexamethasone in our hospital from May 2013 to June 2015. Lenalidomide 25 mg was taken orally daily for 21 days and resting for 7 days, and dexamethasone 10 mg was taken orally daily on the day 1-4, 7-10 and 13-16. The regimens were Rd (lenalidomide and dexamethasone, n = 12), and RCd (lenalidomide, ifosfamide and dexamethasone, n = 7).

RESULTSAmong 19 patients received 1 cycle of treatment 3 patients achieved complete remission (CR), 3 patients achieved very good partial remission (VGPR), 10 patients achieved partial remission (PR) and 3 patients in stable disease (SD) with an overall response rate (ORR = CR + VGPR + PR) of 84%; their ORR rate was 89% after 2 cycles of treatment. In the early stage of treatment, the renal function was improved in 4 out of 5 patients with renal dysfunction. And the common adverse reactions were hematologic toxicity in 4 patients, 1 degree rash in 5 patients, and gastrointestinal side effects in 4 patients.

CONCLUSIONThe lenalidomide plus dexamethasone regimen has a good anti-multiple myeloma effect, which can control the disease rapidly and overcome the multidrug resistance in MM, improving the poor prognosis with renal dysfunction, and showing high remission rate in the patients exposed to bortezomib with low toxicity.

Antineoplastic Combined Chemotherapy Protocols ; Dexamethasone ; administration & dosage ; therapeutic use ; Humans ; Ifosfamide ; therapeutic use ; Multiple Myeloma ; drug therapy ; Remission Induction ; Thalidomide ; administration & dosage ; analogs & derivatives ; therapeutic use

This study evaluated the effects of prolonged primary chemotherapy in retinoblastoma. The data for 27 eyes in 22 children who were treated for retinoblastoma with up to 13 cycles of primary chemotherapy was reviewed. The chemotherapy consisted of etoposide, vincristine, and either carboplatin or ifosfamide. In bilateral retinoblastoma, 1 eye was in each Ia, Ib, and Va, according to the Reese-Ellsworth classification, 2 in each IIa, IIIa, and IIIb, 4 in IIb, and 5 in IVa. Enucleation was performed in 1 in IIa and 1 in Va. In unilateral, 1 was in each IIa, IIIa, IVa, IVb, and Vb, and 4 in Va. Enucleation was performed in 8 with the exception of 1 in IIa. Complete regression was observed in 17 eyes (12 patients). There was no toxicity severe enough to delay treatment. Prolonged primary chemotherapy can be considered as an alternative treatment for retinoblastoma in III or less.
Antineoplastic Agents/administration& dosage ; Antineoplastic Agents, Alkylating/administration& dosage ; Antineoplastic Agents, Phytogenic/administration& dosage ; Antineoplastic Combined Chemotherapy Protocols/*administration& dosage ; Carboplatin/administration& dosage ; Child, Preschool ; Drug Administration Schedule ; Etoposide/administration& dosage ; Eye Enucleation ; Human ; Ifosfamide/administration& dosage ; Infant ; Retinal Neoplasms/*drug therapy/surgery/ultrasonography ; Retinoblastoma/*drug therapy/surgery/ultrasonography ; Retrospective Studies ; Vincristine/administration& dosage

OBJECTIVETo evaluate the efficacy and safety of the ICE regimen (iphosphamide + carboplatin + etoposide) used in treating children with hepatoblastoma in the Shanghai Children's Medical Center.

METHODSFrom June 2000 to June 2008, 14 children with newly diagnosed hepatoblastoma (7 males and 7 females) were enrolled. Their median age on diagnosis was 1.33 years (range: 0.25-8.25 years). Six patients had stage I disease, 1 had stage II, 5 had stage III, and 2 had stage IV diseases. Thirteen children had markedly increased serum AFP level, and 1 had normal serum AFP level. Multidisciplinary co-operation treatment was performed. Eight patients had primary surgery while 3 patients had pre-operation chemotherapy before surgery. ICE chemotherapy regimen was used. Totally, 73 courses of chemotherapy were administered for the 14 children and 25 out of the 73 courses were performed before operation.

RESULTSTwelve patients responded to the treatment (85.7%) and 2 failed. Ten patients (71.4%) achieved complete remission after treatment, and two had partial remission. By July 31st, 2008, 9 patients survived without any event, with a median follow-up duration of 35 months (range: 16-96 months). The 5-year overall survival rate was 70.71+/-12.37%, and the 5-year event-free survival rate was 64.29+/-12.81%. One patient had disease relapse and two patients were lost to follow-up after they achieved partial remission.

CONCLUSIONSThe ICE regimen combined with operation is effective and safe in treating children with hepatoblastoma.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carboplatin ; administration & dosage ; Child ; Child, Preschool ; Etoposide ; administration & dosage ; Female ; Hepatoblastoma ; drug therapy ; Humans ; Ifosfamide ; administration & dosage ; Infant ; Liver Neoplasms ; drug therapy ; Male

The study was aimed to evaluate the effect of IEMAD (modified MIME) composed of isofosfamide, VM26 or VP16, methotrexate, cytarabine, dexamethasone or methylprednisolone, in treatment of refractory or relapsed non-Hodgkin's lymphoma. Twenty-five patients with refractory or relapsed non-Hodgkin's lymphoma (11 refractory NHL patients, 14 relapsed NHL patients) were treated with IEMAD regimen. The results showed that the complete remission rate was 24.0% (6/25) and the partial remission rate was 28.0%, having an overall response rate of 52%. The median survival duration was 13 months and the median duration of progression-free survival was 8 months. The most frequent complications were gastrointestinal complaint (nausea, vomiting etc.) and myelosuppression. No treatment related mortality was found. It is concluded that the IEMAD (modified MIME) regimen may be a safe and effective regimen that can be used in treatment of patients with refractory or relapsed non-Hodgkin's lymphoma who did not respond to other regimens.
Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Cytarabine ; administration & dosage ; Dexamethasone ; administration & dosage ; Drug Administration Schedule ; Etoposide ; administration & dosage ; Female ; Humans ; Ifosfamide ; administration & dosage ; Lymphoma, Non-Hodgkin ; drug therapy ; pathology ; Male ; Methotrexate ; administration & dosage ; Middle Aged ; Mitoguazone ; administration & dosage ; Recurrence

We experienced a case of primary renal synovial sarcoma in a 32 year-old woman. On admission, she complained of intermittent abdominal pain. On radiologic examination, a 12 X 10 cm-sized soft tissue mass was detected on the left kidney. The tumor had histologic and immunophenotypic features that were consistent with spindle cell type monophasic synovial sarcoma. Four months after complete resection of the tumor, a unilateral hematogenous metastasis developed in the lung. She was treated with combined chemotherapy of doxorubicin and ifosfamide every four weeks, and complete remission was achieved. We herein describe the case with a brief review.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Doxorubicin/administration & dosage ; Female ; Human ; Ifosfamide/administration & dosage ; Kidney Neoplasms/diagnosis/*surgery ; Lung Neoplasms/diagnosis/*drug therapy/*secondary ; Remission Induction ; Sarcoma, Synovial/diagnosis/*drug therapy/*secondary/surgery

The aim of this trial was to investigate the efficacy and toxicity of combination chemotherapy with etoposide and ifosfamide (ETI) in the management of heavily pretreated recurrent or persistent epithelial ovarian cancer (EOC). Patients with recurrent or persistent EOC who had measurable disease and at least two prior chemotherapy participating in this phase II trial were to receive etoposide at a dose of 100 mg/m2/day intravenously (IV) on days 1 to 3 in combination with ifosfamide 1 g/m2/day IV on days 1 to 5, every 21 days. Thirty-seven patients were treated; about 78% had previously received more than two separate regimens. The response rate (RR) was 18.9% and median duration of response was 7 months (range, 1-15). Treatment free interval prior to ETI (TFI) has significant correlation with RR rate (P=0.034). Patients (n=6) with TFI > or =6 months had 50% of RR, while patients (n=31) with TFI <6 months had 12.9%. Median survival was 9 months at a median follow-up of 9.2 months. Grade 3 or 4 toxicities included neutropenia in 20.1% of the 139 cycles of ETI, anemia in 7.2% and thrombocytopenia in 8.6%. The ETI produces relatively low toxicity and modest activity in heavily pretreated recurrent or persistent EOC. This is significant in patients with TFI > or =6 months.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Etoposide/administration & dosage/*therapeutic use ; Female ; Humans ; Ifosfamide/administration & dosage/*therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local/*drug therapy ; Ovarian Neoplasms/*drug therapy/mortality ; Survival Rate ; Treatment Outcome

OBJECTIVEAutologous peripheral blood stem cell transplantation (APBSCT) is an important method for treatment of malignant solid tumors in children. The mobilization and collection of blood stem cells is crucial for APBSCT. This study aimed to evaluate the clinical efficacy of mobilization and collection of blood stem cells by CIE or IEV chemotherapy protocol in APBSCT in children with neuroblastoma (NB) or rhabdomyosarcoma.

METHODSThe protocols of CIE (cisplatin, etoposide) and IEV (vincristine, dosfamide, etoposide) were used as mobilization chemotherapy in 8 cases of NB with stage IV and 3 cases of rhabdomysacoma with stage III, respectively. The results of the mobilization of blood stem cells were observed.

RESULTSOf the 11 cases, mononuclear cells (MNC) and CD34+ cells were successfully collected and the volume of MNC and CD34 averaged (5.55 ± 1.43)× 10(8)/kg and (4.88 ± 2.48) × 10(6)/kg, respectively. No severe complications were observed during the mobilization and collection. A rapid hemopoietic reconstitution was observed in 10 children after APBSCT. One with NB out of the 10 children died of left heart failure 32 days after APBSCT. Others (9 cases) showed a nearly normal result of routine peripheral blood test 60 days after APBSCT.

CONCLUSIONSCIE or IEV protocol is effective and safe for the mobilization and collection of peripheral blood stem cells in children with NB or rhabdomysacoma.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; pharmacology ; Child ; Child, Preschool ; Epirubicin ; administration & dosage ; Etoposide ; administration & dosage ; Female ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cell Mobilization ; adverse effects ; methods ; Humans ; Ifosfamide ; administration & dosage ; Male ; Neuroblastoma ; therapy ; Peripheral Blood Stem Cell Transplantation ; Recombinant Proteins ; Rhabdomyosarcoma ; therapy ; Transplantation, Autologous

Adenocarcinoma ; secondary ; therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; therapy ; Carcinoma, Squamous Cell ; secondary ; therapy ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; analogs & derivatives ; Finger Phalanges ; surgery ; Follow-Up Studies ; Humans ; Ifosfamide ; administration & dosage ; Lung Neoplasms ; pathology ; therapy ; Male ; Middle Aged ; Radiotherapy, Conformal

OBJECTIVE: To evaluate the efficacy and tolerability of a neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy in patients with locally advanced cervical carcinoma. METHODS: Patients with histologically confirmed locally advanced cervical carcinoma, aged > or =18 years, were treated with intravenous ifosfamide 5,000 mg/m2 and mesna 5,000 mg/m2, on day 1; intravenous paclitaxel 175 mg/m2 and cisplatin 75 mg/m2, on day 2; every 3 weeks for three cycles. Following chemotherapy, operable patients underwent radical hysterectomy and pelvic lymphadenectomy, and, if necessary, adjuvant radiotherapy. RESULTS: One hundred fifty-two patients with median age 53 years (range, 24 to 79 years), FIGO stage IIB in 126 (89%), were treated with chemotherapy for median 3 cycles (range, 1 to 3). Treatment was delayed or withdrawn in 23 patients (15%). One hundred thirty-nine patients (91%) underwent surgery. Postchemotherapy pathological complete response rate was 18% (25 patients). Postoperative radiotherapy was administered in 100 patients (72%). The 5-year overall survival and progression-free survival were 87.3% (95% confidence interval [CI], 84.5 to 90.3) and 76.4% (95% CI, 73.5 to 79.5), respectively. CONCLUSION: Neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy was feasible and effective in the treatment of locally advanced cervical carcinoma patients with older age and more advanced disease stage than reported in previous studies. Hematological and renal toxicity could be carefully prevented.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Squamous Cell/*drug therapy/mortality/pathology ; Cisplatin/*administration & dosage/adverse effects ; Disease Progression ; Feasibility Studies ; Female ; Humans ; Ifosfamide/*administration & dosage/adverse effects ; Middle Aged ; Neoadjuvant Therapy ; Paclitaxel/*administration & dosage/adverse effects ; Retrospective Studies ; Treatment Outcome ; Uterine Cervical Neoplasms/*drug therapy/mortality/pathology ; Young Adult

Regardless of improvement in cure of Rhabdomyosarcoma (RMS), the results in treatment of advanced stage of RMS in children are still dismal. Recently, high-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (HDC/APBSCT) has been tried to manage the advanced high-risk RMS patients. We investigated the effectiveness of HDC/APBSCT by reviewing the clinical records of high-risk pediatric RMS patients in single institute database. Over twenty years, 37 patients were diagnosed as RMS with high-risk at the time of first diagnosis. These patients were classified as two groups according to treatment method. The first group was HDC/APBSCT and the other was conventional multi-agent chemotherapy group. Differences of clinical results between the two groups were analyzed. The median age of patients was 5 yr, ranging from 6 months to 15 yr. The 5-yr event free survival rate (EFS) of all patients was 24.8% +/- 4.8%. HDC/APBSCT group and conventional multi-agent chemotherapy group were 41.3% +/- 17.8% and 16.7% +/- 7.6% for 5-yr EFS, respectively (P = 0.023). There was a significant difference in the result of HDC/APBSCT between complete remission or very good partial response group and poor response group (50% +/- 20.4% vs 37.5% +/- 28.6%, P = 0.018). HDC/APBSCT can be a promising treatment modality in high-risk RMS patients.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carboplatin/administration & dosage ; Child ; Child, Preschool ; Disease-Free Survival ; Etoposide/administration & dosage ; Female ; Humans ; Ifosfamide/administration & dosage ; Infant ; Male ; *Peripheral Blood Stem Cell Transplantation ; Retrospective Studies ; Rhabdomyosarcoma/*drug therapy/mortality/pathology ; Survival Rate ; Transplantation, Autologous ; Treatment Outcome