Activity and safety of combination chemotherapy with methotrexate, ifosfamide, l-asparaginase and dexamethasone (MILD) for refractory lymphoid malignancies: a pilot study.

摘要: Optimal salvage chemotherapy has not been established for lymphoid malignancy, which is refractory to the conventional cyclophosphamide, doxorubicin, vincristine, and prednisone regimen. To explore an effective regimen, we conducted a phase I pilot study of combination with methotrexate, ifosfamide, l-asparaginase dexamethasone (MILD), are unaffected by MDR1-encoded P-glycoprotein. A total 18 patients lethal malignancy were enrolled over 2-yr period. The median age was 63 yr. Eleven had T/NK-cell malignancies, six B-cell one diagnosed blastic plasmacytoid dendritic cell neoplasm. Patients aged ≥60 <60 yr planned receive set starting doses methotrexate should induce myelosuppression. completed two courses MILD therapy. Treatment-related death because systemic mucormycosis observed in patient. Major treatment-related adverse events grade 3 or more hematologic toxicities, included lymphopenia corresponding dose-limiting toxicity. most common non-hematologic toxicity febrile neutropenia. Of 14 evaluated patients, three achieved complete response, four showed partial response. overall response rate 57%. It very interesting that all seven responders malignancies. therapy feasible presented acceptable efficacy malignancies be further evaluated.