Ifosfamide and etoposide-based chemotherapy as salvage and mobilizing regimens for poor prognosis lymphoma

We treated 40 patients with poor prognosis lymphomas, Patients with non-Hod gkin's lymphoma (NHL, n = 14) received MINE chemotherapy (mesna, ifosfamide 1330 mg/m(2) and etoposide 65 mg/m(2) by i.v. infusions on days 1-3, mitox antrone 8 mg/m(2) i.v. on day 1), and those with Hodgkin's disease (EHD, n= 26) received VIM chemotherapy (mesna, ifosfamide 1200 mg/m(2) by i.v. infus ion on days 1-5, etoposide 90 mg/m(2) by i.v. infusion on days 1, 3 and 5, and methotrexate 30 mg/m(2) i.v. on days 1 and 5), Chemotherapy was followe d by G-CSF (10 or 16 mu g/kg in two divided doses daily) to mobilize PBSC, We performed 134 aphereses (median three leukaphereses per patient) startin g on either day 13 (median; VIM) or day 12 (median; MINE), The median yield was 9.9 x 10(6) CD34(+) cells/kg and 53.2 x 10(4) CFU-GM/kg for VIM, and 1 3.5 x 10(6) CD34(+) cells/kg and 53.4 x 10(4) CFU-GM/kg for MINE. Except fo r predictable myelosuppression, no serious toxicity was seen. Response rate using MINE was 63% (18% CR, 45% PR) and using VIM 50% (17% CR, 33% PR), We conclude that VIM and MINE are effective and well-tolerated salvage regime ns in patients with lymphomas and, followed by G-CSF, they also exhibit goo d capacity to mobilize stem cells in a predictable time interval.