Mitoxantrone in combination with prednimustine in treatment of unfavorable non-Hodgkin lymphoma

Abstract

Mitoxantrone (Novantrone) and prednimustine (Sterecyt) are both active as single agents in the treatment of unfavorable non-Hodgkin lymphoma (UNHL). The efficacy and toxicity of the combination of these agents (NOSTE) was evaluated in 28 patients with advanced histopathologically proven UNHL who were not eligible for aggressive conventional chemotherapy. The median age was 68, range 45-84. Sixteen patients were previously untreated. Eleven patients had received doxorubicin or epidoxorubicin containing regimens and 1 patient had received CVP as first line therapy. MUGA scan was used in monitoring cardiac function in patients with cardiac risk. Novantrone was administered at a dose of 8 mg/m2 IV on days 1 and 2 and Sterecyt as an absolute dose 100 mg/less than or equal to 1.6 m2-150 mg/greater than 1.6 m2 on days 1 through 5. The regimen was repeated every 4th week. The number of courses per patient ranged from 2 to 10. Objective response was obtained in 22 (78%) patients (20 CR and 2 PR). No response occurred in 6 patients (4 SD, 2 PD). Decreased left ventricular ejection fraction was recorded in 1 patient who suffered from asthma and ischemic heart disease. Hematological toxicity was tolerable. Gastrointestinal toxicity was rare. No hair loss was observed. After a median follow-up of 28 months the crude survival was 46%. Twelve of twenty complete responders are still in remission, the median duration of remission is 28.3 months, range 15-37. NOSTE in this pilot study showed a high response rate, good tolerance and mild toxicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas

“…It was derived from the combination of prednimustine and mitoxantrone (PmM), which was introduced by Landys in 1988, who reported a high remission rate in patients with recurrent and untreated, indolent lymphomas. 13 A subsequent trial by the German LowGrade Lymphoma Study Group (GLSG) confirmed those data and also showed significantly greater antilymphoma activity and a more favorable toxicity profile for PmM when it was compared randomly with cyclophosphamide, vincristine, and prednisone (COP). 14 When prednimustine, which is an ester of chlorambucil and prednisone, was taken off of the market because of a high rate of secondary acute myeloid leukemias and myelodysplastic syndromes, chlorambucil and prednisone were used as separate agents.…”

Treatment of extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) with mitoxantrone, chlorambucil and prednisone (MCP)

“…To our knowledge, no results from the combination of mitoxantrone, chlorambucil and prednisone (MCP), which has widely been applied in various other types of indolent lymphomas [15][16][17][18], have been reported in patients with MALT lymphoma. In view of the fact that chlorambucil is already an effective and frequently used treatment option in MALT lymphomas [13,[19][20][21] and mitoxantrone shows high activity in the treatment of indolent lymphoma [15,16,18], this combination appears to be an attractive treatment option. We have therefore performed a retrospective analysis of our results with MCP in the therapy of patients with MALT lymphoma.…”

Primary Bilateral Renal Centrocytic Non-Hodgkin’s Lymphoma as a Cause of Renal Failure

“…Immunohistologic marker studies of the biopsy specimen revealed a B-ecll phenotype. After ini tiating acute hemodialysis we consequently treated our patient with 2 mg of vincristine on day l and 100 mg of prednisone for 5 days followed l week later by a more aggressive chemotherapy regimen [4] consisting of prednimustine and mitoxantronc (PmM protocol). According to the age of our patient, we reduced mitoxantronc to 8 mg/m2 on day l. while the prednimustine dosage was 100 mg/m2 on days l-5 every 4 weeks for 3 cycles.…”