VIP (ETOPOSIDE, IFOSFAMIDE AND CISPLATINUM) AS A SALVAGE INTENSIFICATION PROGRAM IN RELAPSED OR REFRACTORY HODGKINS-DISEASE

Forty-two patients with refractory (15 patients) or relapsed (27 patie nts) Hodgkin's disease (HD) were included in a prospective single cent er study evaluating the efficacy of a regimen VIP combining etoposide 75 mg/m(2)/day days 1-5, ifosfamide 1.2 g/m(2)/day days 15 and cisplat inum 20 mg/m(2)/day days 1-5, one course every 4 weeks as salvage ther apy in patients with refractory or relapsed Hodgkin's disease, potenti ally eligible for high-dose chemotherapy with reinjection of hemato po ietic stem cells (HSC). If patients were considered chemosensitive aft er two courses of VIP, high-dose chemotherapy followed by the reinject ion of HSC was planned. After two courses of VIP, 67% achieved an obje ctive response including 38% complete responses. Overall, 28 patients went on to high-dose therapy with reinjection of HSC, and 46% of graft ed patients are in a sustained complete remission. When the overall pa tient population is considered, 33% are in complete remission (CR) wit h a median follow-up of 37 months. A CR of less than 12 months and ref ractory disease were associated with a poor survival. These results sh owed that the VIP regimen is effective in relapsed or refractory HD an d allows high-dose therapy to be given in the case of most responding patients. However, results in patients with refractory disease or a fi rst complete remission of less than 12 months need to be further impro ved.