R. Mansberg et al., CYTOSINE-ARABINOSIDE AND ETOPOSIDE (CARE) IN RELAPSED AND REFRACTORY NON-HODGKINS-LYMPHOMA, Medical oncology and tumor pharmacotherapy, 9(4), 1992, pp. 173-176
Twelve patients with relapsed or refractory non-Hodgkin's lymphoma (NH
L) were treated with a 5 day protocol of high dose cytosine arabinosid
e 3g/m2 and etoposide 200 mg/m2(CARE) daily for 4 days for either 1 or
2 cycles together with alternating intrathecal cytosine arabinoside a
nd methotrexate. Seven men and 5 women aged 18 to 65 years (median age
47.5 years) have received a total of 19 cycles. Six patients had Stag
e III and 6 had Stage IV disease, all with marrow involvement. Three p
atients had diffuse small lymphocytic NHL, 3 had diffuse large cell NH
L, 3 had diffuse small cleaved NHL and 3 remaining patients had diffus
e mixed small and large cell NHL, lymphoblastic NHL and Burkitt's. Six
patients (50%) achieved complete remission (3-44 months), four of who
m subsequently underwent successful autologous bone marrow transplanta
tion and a fifth has had marrow harvested in preparation for ABMT. One
patient achieved partial remission and 5 patients had no response to
CARE. Ten patients had nadir granulocyte counts less than 0.5x10(9)/l
and all required red cell (range 2-11 units) and platelet (range 6-130
units) transfusions. The platelet nadir was less than 20x10(9)/l in a
ll patients. One patient with refractory disease succumbed to pulmonar
y haemorrhage while three other patients developed reversible toxicity
with severe mucositis, prolonged diarrhoea and acute renal failure. O
ne patient with refractory disease died with a progressive neuropathy.