Combined ifosfamide, etoposide and oxalipatin chemotherapy, a low-toxicity regimen for first-relapsed or refractory Hodgkin lymphoma after ABVD/EBVP: a prospective monocentre study on 34 patients

Br J Haematol. 2011 Apr;153(2):191-8. doi: 10.1111/j.1365-2141.2011.08594.x. Epub 2011 Mar 8.

Abstract

Around 20% of Hodgkin lymphoma (HL) patients are refractory to first-line therapy with ABVD (adriamycin-bleomycin-vinblastine-dacarbazine) or relapse after complete remission. Salvage regimens frequently have delayed courses or require dose-reduction because of haemotoxicity. We evaluated the IVOx (ifosfamide-etoposide-oxaliplatin) salvage regimen in terms of response rate, toxicity and stem-cell mobilization. Thirty-four patients with relapsed/refractory HL after anthracycline-containing chemotherapy prospectively received IVOx, consisting of ifosfamide (1500 mg/m(2) days 1-3), etoposide (150 mg/m(2) days 1-3) and oxaliplatin (130 mg/m(2) day 1). Patients <65 years old received high-dose therapy followed by autologous stem-cell transplantation (HDT-ASCT). Response was assessed by computed and positron-emission tomographies. Overall and complete response rates were 76% and 32%, respectively, after 2 cycles. Three episodes of febrile neutropenia occurred, and three patients required dose-reductions. Twenty-six patients underwent HDT-ASCT. With median follow-up at 5 years, the 5-year overall and event-free survival rates were 74% and 63%, respectively. IVOx is a well-tolerated outpatient regimen for relapsed HL, that does not hamper stem-cell mobilization, achieves good response rates and compares favourably with previously published salvage regimens.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bleomycin / administration & dosage
  • Dacarbazine / administration & dosage
  • Disease-Free Survival
  • Doxorubicin / administration & dosage
  • Epirubicin / administration & dosage
  • Etoposide / administration & dosage*
  • Female
  • Follow-Up Studies
  • Hodgkin Disease / mortality*
  • Hodgkin Disease / prevention & control*
  • Humans
  • Ifosfamide / administration & dosage*
  • Male
  • Middle Aged
  • Organoplatinum Compounds / administration & dosage*
  • Oxaliplatin
  • Prospective Studies
  • Recurrence
  • Stem Cell Transplantation*
  • Survival Rate
  • Transplantation, Autologous
  • Vinblastine / administration & dosage

Substances

  • Organoplatinum Compounds
  • Oxaliplatin
  • Bleomycin
  • Epirubicin
  • Vinblastine
  • Etoposide
  • Dacarbazine
  • Doxorubicin
  • Ifosfamide

Supplementary concepts

  • ABVD protocol
  • EBVD protocol