IDARUBICIN AND HIGH-DOSE CYTARABINE - A NEW SALVAGE TREATMENT FOR REFRACTORY OR RELAPSING NON-HODGKINS-LYMPHOMA

Twenty three patients with relapsing (n = 11) or refractory (n = 12) n on-Hodgkin's lymphoma (NHL) to one or two prior anthracycline based co mbination chemotherapy regimens were treated as second or third line r egimen with 3 induction cycles of Idarubicin (IDA) (7 mg/m(2)/d IV d1- d3) and high dose cytarabine (HD Ara-C) (1 g/m(2)/12 h IV d1-d3), each cycle was repeated every 3 weeks. Responding patients received a main tenance therapy with monthly cycles of IDA : 15 mg/m(2)d1-d3, Etoposid e 100 mg/m(2)d1-d3, both by oral route. Twenty two patients are evalua ble and we observed 13 CR and I PR with an overall response rate of 61 % (14/23; 95% Cl = 38.5% 80.3%). The median time to progression was 3 2 months (6.5 - 63 + m.). The response rate to IDA-HD Ara C was not di fferent for patients with (n = 14) or without (n = 9) objective respon se to the last prior therapy. The main toxicity was hematological : al l patients experienced grade 4 neutropenia and 22 patients had grade 4 thrombopenia, but there were no toxic deaths. IDA and HD-Ara-C combin ation is highly effective in refractory or relapsed NHL. As hematologi cal toxicity was the limiting factor for further escalation of dose-in tensity, further studies might include hematopoietic growth factors su pport in the therapeutic scheme.