Faculty Collaboration Database

Ifosfamide and vinorelbine is an effective reinduction regimen in children with refractory/relapsed Hodgkin lymphoma, AHOD00P1: a children's oncology group report. Pediatr Blood Cancer 2015 Jan;62(1):60-4

Date

10/14/2014

Pubmed ID

25308760

Pubmed Central ID

PMC4465390

DOI

10.1002/pbc.25205

Scopus ID

2-s2.0-84922830869 (requires institutional sign-in at Scopus site)   22 Citations

Abstract

BACKGROUND: We assessed the safety and efficacy of ifosfamide and vinorelbine (IV) as a less toxic and effective reinduction regimen for pediatric patients with relapsed or refractory Hodgkin Lymphoma.

PROCEDURE: This multi-center Children's Oncology Group phase II pilot study enrolled patients <30 years of age with biopsy-proven Hodgkin Lymphoma in relapse or refractory disease after front-line therapy. Treatment consisted of ifosfamide 3,000 mg/m(2) intravenous infusion over 24 hr on Days 1-4 and vinorelbine 25 mg/m(2) /dose intravenous push on Days 1 and 5 of each 21 day cycle with cytokine support. The study endpoints included estimation of key toxicities (cardiac, hepatic, or renal toxicity or toxic death), the rate of successful peripheral stem cell harvesting, and response after two cycles of therapy.

RESULTS: Sixty-six patients received a median of two cycles of IV. Sixty-four of 66 were heavily pretreated, 4 had refractory disease, 55% were male and 79% had nodular sclerosis HL. The primary toxicities were hematologic. Harvested peripheral stem cells were sufficient for autologous transplantation in 46 of 54 patients for whom stem cell collection was attempted. The overall response rate (72%; 95% CI 59-83%) permitted the majority of patients to undergo subsequent stem cell transplantation.

CONCLUSIONS: IV is a safe and effective re-induction regimen for salvage of pediatric patients with relapsed or refractory Hodgkin Lymphoma with an excellent response rate and success of post chemotherapy stem cell harvest. It avoids the use of etoposide, an agent associated with secondary malignancy after stem cell transplantation.

Author List

Trippett TM, Schwartz CL, Guillerman RP, Gamis AS, Gardner S, Hogan S, London WB, Chen L, de Alarcon P

Author

Cindy L. Schwartz MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols
Child
Child, Preschool
Combined Modality Therapy
Drug Resistance, Neoplasm
Female
Follow-Up Studies
Hodgkin Disease
Humans
Ifosfamide
Infant
Infant, Newborn
Male
Neoplasm Recurrence, Local
Neoplasm Staging
Peripheral Blood Stem Cell Transplantation
Pilot Projects
Prognosis
Remission Induction
Salvage Therapy
Survival Rate
Transplantation, Autologous
Vinblastine
Young Adult