IFOSFAMIDE, MITOXANTRONE AND ETOPOSIDE (VIM) AS SALVAGE THERAPY OF LOW TOXICITY IN NON-HODGKINS-LYMPHOMA

Patients with non-Hodgkin's lymphoma (NHL) who fail to respond to firs t-line treatment or relapse after having shown complete or partial rem ission have a poor prognosis, especially in high-grade NHL. Several sa lvage regimens show considerable toxicity and a poor long-term outcome . In this retrospective study we analyzed data of 55 patients (34 men and 21 women) with a median age of 66 years (range: 18-89). The combin ation chemotherapy (VIM) consisted of VP-16 (etoposide) 65 mg/m(2), if osfamide 650 mg/m(2) and mitoxantrone 3 mg/m(2) and was administered o n 3 consecutive days along with mesna as uroprotection. Patients were treated for refractory disease or relapse and did not qualify for high -dose chemotherapy and ABMT, Stages according to the An Arbor classifi cation were: stage I/16, II/4, III/8 and IV/37 patients. Thirty-three patients suffered from high-grade and 22 from low-grade NHL. Toxicity (WHO recommendations) was very mild. High-grade NHL showed a better re sponse rate (18/33, 46%) than low-grade NHL (7/22, 36%). Overall respo nse was 41% (12 CR and 11 PR) with a median duration of 36 months (ran ge: 6-57 months). The combination therapy investigated exhibits mild t oxicity even in extensively pretreated or elderly patients, The overal l response rate of 41% might be improved by increased dosage and growt h factor support.