Ninety-six-hour paclitaxel infusion with mitoxantrone and ifosfamide/mesnaand consolidation with ESHAP for refractory and relapsed non-Hodgkin's lymphoma

A prospective phase II study was carried out in 48 patients with relapsed o r refractory non-Hodgkin's lymphoma using paclitaxel 27.5 mg/M-2 IV by cont inuous infusion over 24 hours daily on days 1, 2, 3, and 4 in combination w ith mitoxantrone 8 mg/M-2 IV on day 1 and ifosfamide/mesna 1.33 grams/M-2 I V daily on days 1, 2, and 3 (MINT). Responding patients completed four cycl es of MINT and were consolidated with etoposide, solumedrol [methylpredniso lone], high-dose cytarabine [Ara-C], and platinum (ESHAP). Forty-eight pati ents were entered in the study between 1994 and 1996 at The University of T exas M. D. Anderson Cancer Center. Overall response after the first four cy cles of MINT was 67% (16% complete response [CR]+ 51% partial response [PR] ) and after consolidation with ESHAP it was 49% (26% CR + 23% PR). Variable s associated with an improved CR rate and better failure-free survival incl uded the number of prior treatments and the response to prior treatment. A comparison with a similar group of patients treated with mesna, ifosfamide, mitoxantrone, and etoposide (MINE)-ESHAP revealed no major differences in outcome.