Abstract | BACKGROUND: 'Molecular response' is being investigated as a therapeutic goal in follicular lymphoma (FL). High response rates in FL with the fludarabine combination 'FMD' have been associated with 'molecular remission'. A phase II study of FMD in FL was therefore conducted. PATIENTS AND METHODS: Fifty-four patients, ten of whom were newly diagnosed received FMD. Forty-four percent of the previously treated patients had 'chemoresistant' disease. Treatment comprised: fludarabine 25 mg/m2 days 1-3, mitoxantrone 10 mg/m2 day 1, and dexamethasone 20 mg days 1-5. Blood/bone marrow was collected for quantitation of t(14;18) by 'real-time' PCR. RESULTS: The overall response rate was 37 of 54 (69%), complete responses being seen in 11 patients (20%), with no difference between newly diagnosed and the previously treated patients. However, the response rate in 'chemosensitive' relapse was 84% compared to 44% in patients in whom the last prior regimen had failed. Molecular responses were seen in 17 of 25 and PCR negativity in 8 of 25, although molecular and clinical responses did not always correlate. Toxicity was moderate, 19 patients required admission. However, in 6 of 12 patients, subsequent G-CSF mobilised stem cell harvests failed. CONCLUSIONS: FMD was well tolerated but with a lower than expected response rate. Molecular responses were seen in the majority of responding patients however, 'molecular remission' was rare.
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Authors | C R Crawley, J M Foran, R K Gupta, A Z Rohatiner, K Summers, J Matthews, I N Micallef, J A Radford, S A Johnson, P W Johnson, J W Sweetenham, T A Lister |
Journal | Annals of oncology : official journal of the European Society for Medical Oncology
(Ann Oncol)
Vol. 11
Issue 7
Pg. 861-5
(Jul 2000)
ISSN: 0923-7534 [Print] England |
PMID | 10997815
(Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article)
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Chemical References |
- DNA, Neoplasm
- Dexamethasone
- Mitoxantrone
- Vidarabine
- fludarabine
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Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, therapeutic use)
- DNA, Neoplasm
(analysis)
- Dexamethasone
(administration & dosage)
- Female
- Humans
- Lymphoma, Follicular
(drug therapy, genetics, pathology)
- Male
- Middle Aged
- Mitoxantrone
(administration & dosage)
- Polymerase Chain Reaction
- Recurrence
- Treatment Outcome
- Vidarabine
(administration & dosage, analogs & derivatives)
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