Hyperfractionated cyclophosphamide with high-doses of arabinosylcytosine and methotrexate (HyperCHiDAM Verona 897)

摘要: BACKGROUND Patients who have aggressive, refractory or recurrent non-Hodgkin lymphomas (NHLs) that are to first-line anthracycline-containing regimens (ACRs) a dismal outcome. Achieving complete remission (CR) is essential for favorable To improve the CR rate in these patients, authors designed new protocol contained hyperfractionated cyclophosphamide (CTX), high-dose arabinosylcytosine (HiDAC), and methotrexate (MTX) delivered sequentially same cycle followed by administration of granulocyte-colony stimulating factor (G-CSF) (HyperCHiDAM Verona 897). METHODS Between February 1998 May 2002, 28 consecutive adult patients (median age, 44 years) with aggressive NHL (B-lineage 21%, T-lineage 7%, Ki-67 percentage > 50 82%) were entered on after they had failed ACRs (15 disease, 6 stable 5 2 partial remission). Patients characteristics as follows: Twenty-two Stage III–IV (78.6%), 19 B symptoms (67.8%), 22 extranodal disease 12 bulky mass (42.8%), 18 elevated lactate dehydrogenase levels (66%), 8 high-intermediate/high International Prognostic Index scores (64.3%). received CTX (300 mg/m2) HiDAC (2 g/m2) every hours Days 2–4 MTX (400 mg/m2 bolus plus 1600 24-hour continuous infusion Day 1 folinic rescue), G-CSF. Subsequently, 15 underwent autologous stem cell transplantation (SCT), 4 allogeneic SCT. RESULTS A was achieved (64.3%), (21.4%), nonresponders progressive (14.3%), there early toxic death (3.5%). Two developed (11.1%). The median follow-up all 35 months (range, from ≥ 74 months). Among CR, 48 32 73 At time current report, 13 (46.42%) event-free. CONCLUSIONS HyperCHiDAM 897 an effective regimen ACRs, it allowed undergo subsequent SCT. Cancer 2005. © 2005 American Society.