IMVP-16/Pd (Ifosfamide/Methotrexate/VP-16/Prednisone) Combination Chemotherapy for the Treatment of Relapsed or Refractory Non-Hodgkin's Lymphoma

Lee,  Ki Hyeong; Park,  Young Iee; Chang,  Heung Moon; Kim,  Tae You; Jung,  Keong Hae; Woo,  In Suk; Im,  Young Hyuck; Heo,  Dae Seog; Bang,  Yung Jue; Park,  Seonyang; Kim,  Byoung Kook; Kim,  Noe Kyeong

J Korean Cancer Assoc > Volume 29(3); 1997 > Article

Original Article

Journal of the Korean Cancer Association 1997;29(3): 486-494.

IMVP-16/Pd (Ifosfamide/Methotrexate/VP-16/Prednisone) Combination Chemotherapy for the Treatment of Relapsed or Refractory Non-Hodgkin's Lymphoma

Ki Hyeong Lee, Young Iee Park, Heung Moon Chang, Tae You Kim, Keong Hae Jung, In Suk Woo, Young Hyuck Im, Dae Seog Heo, Yung Jue Bang, Seonyang Park, Byoung Kook Kim, Noe Kyeong Kim

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

ABSTRACT

PURPOSE:
IMVP-16 (Ifosfamide/Methotrexate/VP-16) regimen consists of drugs that are not commonly used as the first-line therapy of non-Hodgkin's lymphoma. This study was performed to determine the efficacy of this relatively non-cross resistant regimen, with the addition of prednisone, in patients with primary refractory or relapsed non-Hodgkin's lymphoma.
MATERIALS AND METHODS:
Patients with primary refractory or relpased intermediate to high grade non-Hodgkin's lymphoma were treated with ifosfamide (1000 mg/m2 iv, D1-5 with mesna), methotrexate (30 mg/m2 iv, D 3 & 10), VP-16 (100 mg/m2 iv, D 1-3), and prednisone (120 mg devided by 3 doses, D1-5). The treatment was repeated every 3 weeks.
RESULTS:
Between Jan. 1988 and Aug. 1993, thirty eight patients were included. In 33 evaluable patients (4 loss-to follow up and 1 ineligibility) the median age was 49 years. The common histologic types were diffuse large cell type (52%) and immunoblastic type (18%). The proportion of patients with relapsed and refractory NHL was 39% and 61%, respectively. The rate of complete remission was 21% (7/33) and overall response rate was 48% (16/33). The median-response duration was 8 months (1.5~45+). Hematologic toxicities were tolerable. Non-hematologic side effects were also tolerable including stomatitis, peripheral neuropathy, and toxic hepatitis. Three treatment-related deaths were associated with sepsis, ARDS (adult respiratory distress syndrome) and acute gastrointestinal bleeding.
CONCLUSION:
Based on these results, IMVP-16/Pd combination chemotherapy seems to have a moderate efficacy for the relapsed or refractory non-Hodgkin's lymphoma with tolerable toxicities.