Abstract | BACKGROUND AND OBJECTIVE: Low grade non-Hodgkin lymphomas (l-NHL) are rarely showing complete or sustained remissions to conventional chemotherapy. Thus, many therapeutic strategies try to improve the remission rates and outcome in relapsed and refractory l-NHL. Bendamustine (B) is a non-cross resistant alkylating agent shown to be highly effective in lymphoproliferative and other malignant diseases. In an open phase-II study we evaluated the efficacy and toxicity of B in combination with vincristine (O) and prednisolone (P) in heavily pretreated relapsed or refractory l-NHL. PATIENTS AND METHODS: 22 patients (median age 61.5 years, range 39-77 years) with relapsed or refractory low grade NHL: immunocytoma (IC) n = 11, centroblastic-centrocytic (CB-CC) n = 6, centrocytic (CC) n = 2, others n = 3, were treated with BOP as follows: patients up to 75 years: 60 mg/m2 B for 5 days; patients over 75 years: 50 mg/m2 B for 5 days. All patients received 2 mg vincristine (O) on day 1, 100 mg/m2 prednisolone (P) on day 1-5; repetition day 29. Prior to BOP patients were pretreated with 1-4 chemotherapy protocols. An average of 5 courses of BOP were administered (range 2-8). In most patients BOP was followed by a maintenance therapy (IFN-alpha n = 11, chlorambucil n = 4, etoposide n = 2). RESULTS: Objective remission was achieved in 19/22 (86%) patients, complete remission (CR) in 10/22 (45%), partial remission (PR) in 9/22 (41%) and no change (NC) in 3/22 (14%) patients. The mean duration of remission was 16.1 months. Predominant features of side effects of the BOP protocol were myelotoxicity of WHO grade III/IV in 8 of 109 cycles leukopenia (8%), thrombocytopenia 3 cyles (3%) and anaemia in 4 cycles (4%). We observed one WHO grade IV infectious episode. Other side effects were mild and rare. There was a decline of the CD4/8 in more than 50% of patients. However, these changes were not accompanied by a higher rate of infectious episodes. CONCLUSION:
Salvage therapy of refractory and relapsed l-NHL with BOP results in a high objective remission rate. Together with a maintenance therapy most patients achieved a long-term disease-free survival. Myelotoxicity and the inversion of the CD4/CD8 ratio were frequently observed side effects.
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Authors | R Kath, K Blumenstengel, H J Fricke, H D Peters, K Höffken |
Journal | Deutsche medizinische Wochenschrift (1946)
(Dtsch Med Wochenschr)
Vol. 126
Issue 8
Pg. 198-202
(Feb 23 2001)
ISSN: 0012-0472 [Print] Germany |
Vernacular Title | Bendamustin, Vincristin, Prednisolon (BOP) in der Therapie von fortgeschrittenen niedrig malignen Non-Hodgkin-Lymphomen. |
PMID | 11256023
(Publication Type: Clinical Trial, Clinical Trial, Phase II, English Abstract, Journal Article)
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Chemical References |
- Bleomycin
- Vincristine
- Cisplatin
|
Topics |
- Adult
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(administration & dosage, adverse effects, therapeutic use)
- Bleomycin
(administration & dosage, adverse effects)
- Cisplatin
(administration & dosage, adverse effects)
- Female
- Humans
- Lymphoma, Non-Hodgkin
(drug therapy)
- Male
- Middle Aged
- Salvage Therapy
- Treatment Outcome
- Vincristine
(administration & dosage, adverse effects)
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