Low-dose continuous chemotherapy (LBCMVD-56) for refractory and relapsing lymphoma

J. Shamash, J. Walewski, J. Apostolidis, A. M. Wilson, James M Foran, R. K. Gupta, A. Z S Rohatiner, S. M. Kelsey, T. A. Lister

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Although lymphoid malignancies are generally chemosensitive, relapse is common. The use of high-dose therapy can make subsequent cytotoxic therapy intolerable. There is a need to develop regimens with low acute toxicity which are suitable for use in patients post-high dose therapy and following the failure of standard protocols. Patients and methods: Twenty-six patients with lymphomas, fifteen of whom had received high-dose therapy, were treated with a novel regimen consisting of low-dose lomustine, chlorambucil, daily subcutaneous bleomycin, vincristine and methotrexate with dexamethasone on an eight-week cycle (LBCMVD-56). A median of three cycles was given. Results: The overall response rate at 12 weeks was 67% (21% complete remission (CR)) with a median overall survival of 13 months. A symptomatic response was seen in 72%. Previous high-dose therapy did not compromise the response rate. Toxicity was acceptable with grade 3-4 haematological toxicity seen in 27% of cycles, gastrointestinal toxicity seen in 11% and pulmonary toxicity seen in 8%. Thirty-one percent of patients required hospitalisation at some point during this treatment most commonly for neutropenic sepsis. Conclusions: LBCMVD-56 is an inexpensive, outpatient-based regimen with low acute toxicity and a high response rate in this heavily pre-treated group of patients.

Original languageEnglish (US)
Pages (from-to)857-860
Number of pages4
JournalAnnals of Oncology
Volume11
Issue number7
DOIs
StatePublished - 2000
Externally publishedYes

Fingerprint

Lymphoma
Drug Therapy
Therapeutics
Lomustine
Chlorambucil
Bleomycin
Vincristine
Methotrexate
Dexamethasone
Sepsis
Hospitalization
Outpatients
Recurrence
Lung
Survival
Neoplasms

Keywords

  • Low-dose continuous chemotherapy
  • Lymphoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Shamash, J., Walewski, J., Apostolidis, J., Wilson, A. M., Foran, J. M., Gupta, R. K., ... Lister, T. A. (2000). Low-dose continuous chemotherapy (LBCMVD-56) for refractory and relapsing lymphoma. Annals of Oncology, 11(7), 857-860. https://doi.org/10.1023/A:1008355417445

Low-dose continuous chemotherapy (LBCMVD-56) for refractory and relapsing lymphoma. / Shamash, J.; Walewski, J.; Apostolidis, J.; Wilson, A. M.; Foran, James M; Gupta, R. K.; Rohatiner, A. Z S; Kelsey, S. M.; Lister, T. A.

In: Annals of Oncology, Vol. 11, No. 7, 2000, p. 857-860.

Research output: Contribution to journalArticle

Shamash, J, Walewski, J, Apostolidis, J, Wilson, AM, Foran, JM, Gupta, RK, Rohatiner, AZS, Kelsey, SM & Lister, TA 2000, 'Low-dose continuous chemotherapy (LBCMVD-56) for refractory and relapsing lymphoma', Annals of Oncology, vol. 11, no. 7, pp. 857-860. https://doi.org/10.1023/A:1008355417445
Shamash, J. ; Walewski, J. ; Apostolidis, J. ; Wilson, A. M. ; Foran, James M ; Gupta, R. K. ; Rohatiner, A. Z S ; Kelsey, S. M. ; Lister, T. A. / Low-dose continuous chemotherapy (LBCMVD-56) for refractory and relapsing lymphoma. In: Annals of Oncology. 2000 ; Vol. 11, No. 7. pp. 857-860.
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AU - Walewski, J.

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AU - Foran, James M

AU - Gupta, R. K.

AU - Rohatiner, A. Z S

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AU - Lister, T. A.

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AB - Background: Although lymphoid malignancies are generally chemosensitive, relapse is common. The use of high-dose therapy can make subsequent cytotoxic therapy intolerable. There is a need to develop regimens with low acute toxicity which are suitable for use in patients post-high dose therapy and following the failure of standard protocols. Patients and methods: Twenty-six patients with lymphomas, fifteen of whom had received high-dose therapy, were treated with a novel regimen consisting of low-dose lomustine, chlorambucil, daily subcutaneous bleomycin, vincristine and methotrexate with dexamethasone on an eight-week cycle (LBCMVD-56). A median of three cycles was given. Results: The overall response rate at 12 weeks was 67% (21% complete remission (CR)) with a median overall survival of 13 months. A symptomatic response was seen in 72%. Previous high-dose therapy did not compromise the response rate. Toxicity was acceptable with grade 3-4 haematological toxicity seen in 27% of cycles, gastrointestinal toxicity seen in 11% and pulmonary toxicity seen in 8%. Thirty-one percent of patients required hospitalisation at some point during this treatment most commonly for neutropenic sepsis. Conclusions: LBCMVD-56 is an inexpensive, outpatient-based regimen with low acute toxicity and a high response rate in this heavily pre-treated group of patients.

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