COMBINATION SALVAGE CHEMOTHERAPY WITH MIZE (IFOSFAMIDE-MESNA, IDARUBICIN AND ETOPOSIDE) FOR RELAPSING OR REFRACTORY LYMPHOMA

In this study, 54 patients with relapsed or refractory non-Hodgkin's l ymphoma (NHL) were treated in a phase II, multicentric trial with ifos famide-mesna 1500 mg/m(2) TV days 1-3, idarubicin 12 mg/m(2) IV day 1 and etoposide 100 mg/m(2) IV day 1-3 (MIZE). Overall response was 72%; complete response (CR) and partial response (PR) were 46% and 26% res pectively, In Stage I-LI pts CR was 59% and in Stage III-IV pts CPI wa s 40.5%, Patients who relapsed from an initial CR had a 64% CF, rate w hen treated with MIZE, in contrast to refractory disease's patients wh o only had 19% CR (p = 0.004). The group of pts that had an objective response (CR + PR) to front line therapy had a 2 year survival rate of 55% compared with none for refractory disease (p = 0.029) after salva ge therapy. Median survival for the entire group was 17.5 months. Bett er survival was seen in pts who were asymptomatic with low levels of L DH, previous CR, non high-grade histology, and limited disease stage a t relapse. Toxicity was mainly hematologic: 91.5% had neutropenia, (56 .5% grade III-IV), and 9.5% died from infectious complications. Other clinical toxicities including cardiac toxicity were negligible, MIZE c hemotherapy was effective in patients with relapsed and refractory lym phoma and showed limited clinical and cardiac toxicity, Myelosupressio n was the most frequent single toxicity.