METHYL-GAG, IFOSFAMIDE, METHOTREXATE AND ETOPOSIDE (MIME) AS SALVAGE THERAPY FOR HODGKINS-DISEASE - A PROSPECTIVE-STUDY

This study presents the results of a prospective study of methyl-gag, ifosfamide, methotrexate and etoposide (MIME) as salvage regimen for H odgkin's disease (HD) in Sweden. Sixty-four patients with recurrent or refractory HD were treated with MIME between July 1988 and December 1 993. All patients except one had, earlier, been treated with and faile d consecutive or alternating MOPP and ABVD. Median age was 37 yr (rang e 14-73). Twenty patients (31%) achieved a complete remission (CR) and 17 (27%) a partial remission (PR), giving an overall response rate of 58%. The 5-yr survival for all patients was 43%. In a multivariate an alysis, the most important factors predicting a poor survival were the presence of extranodal disease at relapse, male gender and high age. Twenty-nine patients were treated with high-dose chemotherapy with ste m-cell rescue after MIME. Those patients had a similar survival compar ed to the patients responding to MIME but not treated with high-dose c hemotherapy. We conclude that MIME induces remissions in a high propor tion of patients with recurrent and refractory HD with acceptable toxi city. The remissions probably need consolidation, but the nature of th is consolidation is still controversial.