Salvage Chemotherapy with Ifosfamide, Bleomycin, Etoposide, and Procarbazine (IBEP) in CHOP-Resistant Non-Hodgkin’s Lymphomas

1987 ◽  
pp. 431-437
Author(s):  
K. Bremer ◽  
G. Bauer
Keyword(s):  
Salvage Chemotherapy ◽  
Hodgkin's Lymphomas

scholarly journals All advanced stage non-Hodgkin's lymphomas with a polymerase chain reaction amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2 rearrangement at evaluation and after treatment

Blood ◽  
1991 ◽  
Vol 78 (12) ◽  
pp. 3275-3280 ◽  
Author(s):  
JG Gribben ◽  
As Freedman ◽  
SD Woo ◽  
K Blake ◽  
RS Shu ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Salvage Chemotherapy ◽  
Pcr Analysis ◽  
Low Grade ◽  
Advanced Stage ◽  
Chain Reaction ◽  
Additional Information ◽  
Minimal Disease ◽  
Polymerase Chain ◽  
Hodgkin's Lymphomas

Abstract Polymerase chain reaction (PCR) of bcl-2 provides an extremely sensitive method to detect minimal disease in approximately 50% of patients with non-Hodgkin's lymphomas (NHL). In an attempt to determine the clinical usefulness of this technique, we examined the bone marrow (BM) of 152 patients with advanced-stage NHL at the time of evaluation and after induction or salvage chemotherapy before autologous BM transplantation. The BM proved to be an accessible and reproducible tissue source to determine PCR positivity because all of the 102 patients examined had the same PCR-amplifiable breakpoint in their BM and lymph node. At the time of evaluation, PCR analysis in advanced- stage NHL patients added little additional information to morphologic analysis because each technique identified BM infiltration in approximately 70% of patients. PCR was significantly more useful in determining BM infiltration after induction or salvage therapy. At that time, approximately 50% of patients had morphologically normal BM, whereas PCR analysis remained positive in 100% of those with an amplifiable breakpoint. These observations were confirmed in a clinical trial attempting to induce remission in previously untreated low-grade advanced-stage NHL patients. In this series, PCR was positive in all patients after treatment although the BM was histologically uninvolved in 50% of cases, showing that conventional therapy did not eradicate bcl-2-positive cells.

Vinorelbine-based salvage therapy for patients with aggressive leukemias and non-Hodgkin’s lymphomas

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 17563-17563
Author(s):  
S. Morar ◽  
J. Larson ◽  
S. Qazi ◽  
F. Uckun
Keyword(s):  
Salvage Therapy ◽  
Lymphoblastic Leukemia ◽  
Blast Crisis ◽  
Fusion Imaging ◽  
Salvage Chemotherapy ◽  
Outpatient Setting ◽  
Lymphocytic Leukemia ◽  
Standard Response ◽  
Treatment Responses ◽  
Hodgkin's Lymphomas

17563 Background: We treated 26 patients with aggressive lymphohematopoietic malignancies, including 3 chronic myeloid leukemia (CML) patients in blast crisis, 2 chronic lymphocytic leukemia (CLL) patients with rapidly progressive leukemia, 10 acute lymphoblastic leukemia (ALL) patients in therapy refractory relapse, and 11 non-Hodgkin’s lymhoma (NHL) patients (9 in relapse with progressive lymphoma) with vinorelbine-based outpatient salvage chemotherapy. Methods: Patients received vinorelbine-based salvage therapy regimens NND-I (Vinorelbine [Navelbine] 25 mg/m2 d1,d8, Mitoxantrone [Novantrone]10 mg/m2 d1, Dexamethasone [Decadron] 20 mg BID d1 through 7, or NND-II (Vinorelbine 25 mg/m2 d1, Mitoxantrone 10 mg/m2 d1, Dexamethasone 20 mg BID d1 through 7, Fludarabine 25 mg/m2 d1,d2,d3). Rituximab (Rituxan, 375 mg/m2 d1,8,15,29) was used in combination with chemotherapy in patients with CD20 antigen positive malignancies. Treatment responses were evaluated by peripheral blood and bone marrow examinations in patients with leukemia and CT/MRI-PET fusion imaging in patients with non-Hodgkin’s lymphoma using standard response criteria. Results: All patients completed their salvage therapy as an outpatient without infectious disease complications or hospitalizations. Of the 26 patients, 20 (77%) had objective responses, including 14 complete remissions (CR). All 3 CML patients and both CLL patients achieved a CR. Of the 10 ALL patients, 5 achieved a CR and one achieved a partial remission (PR). Of the 11 NHL patients, 4 achieved a CR and 5 achieved a PR. Conclusions: Taken together, these findings demonstrate that patients with high risk/poor prognosis leukemias and non-Hodgkin’s lymphomas can achieve meaningful objective responses in an outpatient setting using vinorelbine-based salvage regimens. No significant financial relationships to disclose.

scholarly journals All advanced stage non-Hodgkin's lymphomas with a polymerase chain reaction amplifiable breakpoint of bcl-2 have residual cells containing the bcl-2 rearrangement at evaluation and after treatment

Blood ◽  
1991 ◽  
Vol 78 (12) ◽  
pp. 3275-3280 ◽  
Author(s):  
JG Gribben ◽  
As Freedman ◽  
SD Woo ◽  
K Blake ◽  
RS Shu ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Salvage Chemotherapy ◽  
Pcr Analysis ◽  
Low Grade ◽  
Advanced Stage ◽  
Chain Reaction ◽  
Additional Information ◽  
Minimal Disease ◽  
Polymerase Chain ◽  
Hodgkin's Lymphomas

Polymerase chain reaction (PCR) of bcl-2 provides an extremely sensitive method to detect minimal disease in approximately 50% of patients with non-Hodgkin's lymphomas (NHL). In an attempt to determine the clinical usefulness of this technique, we examined the bone marrow (BM) of 152 patients with advanced-stage NHL at the time of evaluation and after induction or salvage chemotherapy before autologous BM transplantation. The BM proved to be an accessible and reproducible tissue source to determine PCR positivity because all of the 102 patients examined had the same PCR-amplifiable breakpoint in their BM and lymph node. At the time of evaluation, PCR analysis in advanced- stage NHL patients added little additional information to morphologic analysis because each technique identified BM infiltration in approximately 70% of patients. PCR was significantly more useful in determining BM infiltration after induction or salvage therapy. At that time, approximately 50% of patients had morphologically normal BM, whereas PCR analysis remained positive in 100% of those with an amplifiable breakpoint. These observations were confirmed in a clinical trial attempting to induce remission in previously untreated low-grade advanced-stage NHL patients. In this series, PCR was positive in all patients after treatment although the BM was histologically uninvolved in 50% of cases, showing that conventional therapy did not eradicate bcl-2-positive cells.

Long-term follow-up of patients receiving salvage chemotherapy for intermediate and high grade non-Hodgkin's lymphomas

2006 ◽  
Vol 8 (3) ◽  
pp. 133-140 ◽  
Author(s):  
Raymond H. S. Liang ◽  
Edmond K. W. Chiu ◽  
T. K. Chan ◽  
David Todd ◽  
Ronald P. Ng ◽  
...  
Keyword(s):  
Salvage Chemotherapy ◽  
High Grade ◽  
Long Term Follow Up ◽  
Hodgkin's Lymphomas

Gallium, rituximab, and dexamethasone for relapsed NHL

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8079-8079 ◽  
Author(s):  
S. E. Smith ◽  
K. Wren ◽  
P. J. Stiff ◽  
A. Toor ◽  
T. Rodriguez ◽  
...  
Keyword(s):  
Stem Cell ◽  
Phase Ii ◽  
Stem Cell Transplant ◽  
Large Cell ◽  
Complete Response ◽  
Autologous Stem Cell Transplant ◽  
Salvage Chemotherapy ◽  
Gallium Nitrate ◽  
Cell Transplant ◽  
Hodgkin's Lymphomas

8079 Background: Almost 50% of patients with intermediate grade non-Hodgkin's lymphomas (NHL) treated with standard CHOP- like therapy will have less than a complete response (CR) after treatment or will relapse after obtaining a CR. Salvage chemotherapy followed in responders by an autologous stem cell transplant (ASCT) can be curative. For many patients, this is not an option due to age, comorbidities, or lack of response. A non-cross resistant agent with activity in NHL which could salvage more patients is gallium nitrate Methods: We conducted a phase II clinical trial investigating the combination 3 non-myelosuppressive agents, gallium nitrate, rituximab and dexamethasone (GaRD) for relapsed or refractory DLBCL, MCL or transformed follicular lymphomas. Gallium is given at 200mg/m2 CIV days 1–7, rituximab 375mg/m2 IVPB day 1 and dexamethasone 40 mg po days 1–4. Eligible patients had relapsed or refractory disease and had a SWOG PS ≤3. Patients may have failed prior ASCT or allogeneic SCT. This was a 2 stage, phase II study with initial evaluation after 22 patients of whom at least 10 responders were needed for completion of the study, as determined prior to start of trial Results: We enrolled 22 patients on study. 15 had large cell, 6 had transformed follicular and 1 had mantle cell NHL. Most of these patients were refractory to one or several prior salvage regimens [13/22 (59%)]; all had prior rituximab 22/22 (100%) and 18/22 (82%) had it with there most recent treatment. No patients developed grade 3 or 4 toxicities, except grade 4 lymphopenia in 7/22 (32%). The overall response rate was 10/22 (45%); CR/CRu 8/22 (36%); PR 2/22 (9%); SD 4/22 (18%); and PD 8/22 (36%). Five patients went on to receive stem cell transplant (including 3 allogeneic and 2 ASCT). Two of the responders were patients who had failed a prior stem cell transplant: 1 ASCT failure who remains in CR >18 months and an allograft failure in CR >14 months after relapse. Of the 22, 10 (46%) are alive at a median f/u of 17.2 months, of whom 7 are currently NED Conclusions: This regimen appears to be effective and relatively non-toxic for patients with relapsed and refractory NHL, including stem cell transplant failure. As CR at ASCT may be associated with an improved outcome, a trial of GaRD combined with RICE is planned to improve cytoreduction prior to ASCT in patients with relapsed NHL. No significant financial relationships to disclose.

Proteasome inhibitors as therapeutics

2005 ◽  
Vol 41 ◽  
pp. 205-218
Author(s):  
Constantine S. Mitsiades ◽  
Nicholas Mitsiades ◽  
Teru Hideshima ◽  
Paul G. Richardson ◽  
Kenneth C. Anderson
Keyword(s):  
Multiple Myeloma ◽  
Drug Class ◽  
Proteasome Inhibitors ◽  
Cell Cycle Regulators ◽  
Current State ◽  
Intracellular Mechanism ◽  
Ubiquitin Proteasome ◽  
Proteasome Pathway ◽  
Hodgkin's Lymphomas ◽  
Clinical Research Data

The ubiquitin–proteasome pathway is a principle intracellular mechanism for controlled protein degradation and has recently emerged as an attractive target for anticancer therapies, because of the pleiotropic cell-cycle regulators and modulators of apoptosis that are controlled by proteasome function. In this chapter, we review the current state of the field of proteasome inhibitors and their prototypic member, bortezomib, which was recently approved by the U.S. Food and Drug Administration for the treatment of advanced multiple myeloma. Particular emphasis is placed on the pre-clinical research data that became the basis for eventual clinical applications of proteasome inhibitors, an overview of the clinical development of this exciting drug class in multiple myeloma, and a appraisal of possible uses in other haematological malignancies, such non-Hodgkin's lymphomas.

A Case of Duodenal Neuroendocrine Carcinoma Treated with Amrubicin as Second-line Chemotherapy

2015 ◽  
Vol 24 (3) ◽  
pp. 379-382
Author(s):  
Tadahisa Inoue ◽  
Hitoshi Sano ◽  
Takashi Mizushima ◽  
Hirotada Nishie ◽  
Hiroyasu Iwasaki ◽  
...  
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Distant Metastases ◽  
Salvage Chemotherapy ◽  
Second Line ◽  
Effective Treatment Option ◽  
Second Line Chemotherapy ◽  
Best Response ◽  
Long Term Effect ◽  
Line Chemotherapy

We present the case of a Japanese man in his 60s with duodenal neuroendocrine carcinoma with distant metastases. Chemotherapy with irinotecan plus cisplatin was initiated as a first-line regimen. However, disease progression was observed after only two cycles. Therefore, amrubicin was administered as a second-line chemotherapy. The patient showed a long-term effect of amrubicin therapy, and the best response was a partial response after seven cycles. For duodenal neuroendocrine carcinoma, amrubicin therapy can be considered an effective treatment option as salvage chemotherapy.

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