IMVP-16/Pd (Ifosfamide/Methotrexate/VP-16/Prednisone) Combination Chemotherapy for the Treatment of Relapsed or Refractory Non-Hodgkin's Lymphoma

Lee, Ki Hyeong; Park, Young Iee; Chang, Heung Moon; Kim, Tae You; Jung, Keong Hae; Woo, In Suk; Im, Young Hyuck; Heo, Dae Seog; Bang, Yung Jue; Park, Seonyang; Kim, Byoung Kook; Kim, Noe Kyeong

Abstract

PURPOSE: IMVP-16 (Ifosfamide/Methotrexate/VP-16) regimen consists of drugs that are not commonly used as the first-line therapy of non-Hodgkin's lymphoma. This study was performed to determine the efficacy of this relatively non-cross resistant regimen, with the addition of prednisone, in patients with primary refractory or relapsed non-Hodgkin's lymphoma.
MATERIALS AND METHODS
Patients with primary refractory or relpased intermediate to high grade non-Hodgkin's lymphoma were treated with ifosfamide (1000 mg/m2 iv, D1-5 with mesna), methotrexate (30 mg/m2 iv, D 3 & 10), VP-16 (100 mg/m2 iv, D 1-3), and prednisone (120 mg devided by 3 doses, D1-5). The treatment was repeated every 3 weeks.
RESULTS
Between Jan. 1988 and Aug. 1993, thirty eight patients were included. In 33 evaluable patients (4 loss-to follow up and 1 ineligibility) the median age was 49 years. The common histologic types were diffuse large cell type (52%) and immunoblastic type (18%). The proportion of patients with relapsed and refractory NHL was 39% and 61%, respectively. The rate of complete remission was 21% (7/33) and overall response rate was 48% (16/33). The median-response duration was 8 months (1.5~45+). Hematologic toxicities were tolerable. Non-hematologic side effects were also tolerable including stomatitis, peripheral neuropathy, and toxic hepatitis. Three treatment-related deaths were associated with sepsis, ARDS (adult respiratory distress syndrome) and acute gastrointestinal bleeding.
CONCLUSION
Based on these results, IMVP-16/Pd combination chemotherapy seems to have a moderate efficacy for the relapsed or refractory non-Hodgkin's lymphoma with tolerable toxicities.