Modified Magrath IVAC regimen as second-line therapy for relapsed or refractory aggressive non-Hodgkin's lymphoma in developing countries: The experience of a single center in Brazil

Pereira, Juliana; Bellesso, Marcelo; Pracchia, Luís Fernando; Neto, Abrahão Elias Hallack; Beitler, Beatriz; Macedo, Maria Cristina Martins de Almeida; Dias, Lucia; Dorlhíac-Llacer, Pedro Enrique; Dulley, Frederico Luiz; Chamone, Dalton A. F.

doi:10.1016/j.leukres.2005.10.002

Cited by 7 publications

(6 citation statements)

References 18 publications

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“…Here, the number of HL patients treated clearly is too small to draw definitive conclusions in this subgroup. The 5-yr OS of comparable groups of patients with NHL treated with other salvage regimens and HD-CT ranges from 10-38% as determined on an intention-to-treat analysis (6,(11)(12)(13)(27)(28)(29)(30)(31)(32)(33). A synopsis of recently published studies reporting the Schü tt et al IVAD/CMV as salvage therapy for lymphoma outcome of relapsed or refractory aggressive NHL is given in Table 4.…”

Section: Discussionmentioning

confidence: 99%

Ifosfamide, etoposide, cytarabine, and dexamethasone as salvage treatment followed by high‐dose cyclophosphamide, melphalan, and etoposide with autologous peripheral blood stem cell transplantation for relapsed or refractory lymphomas

Schütt

Passon

Ebeling

et al. 2006

European J of Haematology

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High-dose chemotherapy (HD-CT) with autologous stem cell transplantation is considered to be the treatment of choice for relapsed high-grade non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL) patients, but the optimal treatment has not yet been defined. We evaluated a salvage treatment regimen consisting of conventional cycles with ifosfamide, etoposide, cytarabine, and dexamethasone (IVAD) followed by two cycles of HD-CT consisting of cyclophosphamide, melphalan, and etoposide (CMV) with autologous stem cell support in patients with relapsed or refractory NHL (n = 59) and HL (n = 16). Response to IVAD was complete remission (CR) in 16 patients (21%), partial remission (PR) in 39 patients (52%), stable disease (SD) in 18 patients (24%), and progressive disease (PD) in two patients (2.7%). Of 70 patients treated with HD-CT, 41 patients (59%) showed a CR, 20 patients a PR (29%), eight patients a SD (11%), and one patient a PD (1.4%). The 5-yr overall survival for the entire group of patients was 29%, and for patients with NHL and HL 25%, and 38%, respectively. The respective event-free survival probabilities at 5 yr were 22%, 16%, and 31%. Seven treatment-related deaths due to septicemia (three), cardiac arrhythmia (one), pneumonia (one), pneumonitis (one), and toxic epidermal necrolysis (one) were observed. In multivariate analysis, an International Prognostic Index of > or = 2 and resistant disease to first-line chemotherapy were poor independent prognostic factors for the subgroup of patients with NHL. In conclusion, these results indicate that IVAD/CMV is feasible as a salvage therapy for lymphoma patients. This treatment is currently evaluated with the addition of rituximab.

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Section: Discussionmentioning

confidence: 99%

Ifosfamide, etoposide, cytarabine, and dexamethasone as salvage treatment followed by high‐dose cyclophosphamide, melphalan, and etoposide with autologous peripheral blood stem cell transplantation for relapsed or refractory lymphomas

Schütt

Passon

Ebeling

et al. 2006

European J of Haematology

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“…Patients in complete remission were followed every 2 months in the first year, 3 months in the second year, 6 months in the 3rd to 4th year, and once a year for life after 5 years. The refractory and relapsed patients received an IVAC-modified regimen 16 as salvage therapy, followed by autologous stem cell transplantation. Patients with HIV and severe congestive heart failure were not included in the study.…”

Section: Methodsmentioning

confidence: 99%

Interim fluorine-18 fluorodeoxyglucose PET-computed tomography and cell of origin by immunohistochemistry predicts progression-free and overall survival in diffuse large B-cell lymphoma patients in the rituximab era

Costa

Neto

Siqueira

et al. 2016

Nuclear Medicine Communications

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“…Refractory or relapsed disease was treated using the IVAC (ifosfamide, etoposide, high-dose cytarabine) protocol as salvage therapy. 10 histology and immunohistochemical staining All biopsies were reviewed by a hematopathologist at the Department of Pathological Anatomy of Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP). The GCB-like antigens Bcl-6 and CD10 and the ABC-like antigen MUM1 (multiple myeloma oncogene-1) were investigated by means of immunohistochemical reactions in order to define whether GCB-like DLBCL or ABC-like DLBCL was present.…”

Section: Patients and Treatmentmentioning

confidence: 99%

Bcl-2 protein frequency in patients with high-risk diffuse large B-cell lymphoma

et al. 2010

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COntext and ObjeCtive: Gene expression and immunohistochemical profiling of diffuse large B-cell lymphoma (DLBCL) have revealed important prognostic subgroups: germinal center B-cell-like (GCB-like) DLBCL and activated B cell-like (ABC-like) DLBCL. Although few reports on high-risk DLBCL are available, the prognosis for the GCB-like subgroup has been shown to be better than that of the ABC-like subgroup. The role of Bcl-2 as a predictor of survival in DLBCL cases is unclear and its expression varies between the two subgroups of DLBCL. In this study, we analyzed the frequency and prognostic impact of Bcl-2 protein expression in high-risk DLBCL cases. MethOdS:The prognostic impact of the expression of the proteins CD10, Bcl-6, MUM1 (multiple myeloma oncogene-1) and Bcl-2 on high-risk DLBCL cases was evaluated by means of immunohistochemistry. Seventy-three patients aged 18-60 years were evaluated for all these markers.ReSultS: Twenty-four cases (32.9%) were GCB-like and 49 (67.1%) were ABC-like, with no difference regarding complete remission, disease-free survival or overall survival rates. Twenty-seven patients (37%) showed Bcl-2 expression, which was the only independent factor predicting a worse prognosis for overall survival according to multivariate analysis.COnCluSiOn: Bcl-2 protein was expressed in 37% of the high-risk DLBCL patients, without any difference between the ABC-like DLBCL and GCB-like DLBCL cases. RESUMOCOntextO e ObjetivO: A expressão gênica e imunoistoquímica do linfoma difuso de grandes células B (LDGCB) vem permitindo a identificação de importantes subgrupos prognósticos: LDGCB do centro germinativo (CG) e LDGCB de células B ativadas (CBA). Entretanto, existem poucos dados disponíveis com LDGCB de alto risco, sendo o prognóstico dos LDGCB do CG melhor que os LDGCB de CBA. A participação do Bcl-2 como preditor de sobrevida nos LDGCB não é clara e sua expressão é variável entre os dois subgrupos de LDGCB. Neste estudo é avaliada a frequência e o prognóstico da expressão da proteína Bcl-2 em LDGCB de alto risco. MétOdOS: Foi avaliado o impacto prognóstico da expressão das proteínas CD10, Bcl-6, MUM1 (multiple myeloma oncogene-1) e Bcl-2 por imunoistoquímica em LDGCB de alto risco. Foram avaliados, para todos os marcadores, 73 pacientes com idade de 18 a 60 anos.ReSultadOS: Vinte e quatro (32,9%) pacientes foram classificados como LDGCB do CG e 49 (67,1%) como LDGCB de CBA, sem diferença nas taxas de remissão completa, sobrevida livre de doença e sobrevida global. Vinte e sete (37%) apresentaram expressão de Bcl-2, o qual foi o único fator preditivo independente de pior prognóstico de sobrevida global à análise multivariada.COnCluSãO: A expressão da proteína Bcl-2 ocorreu em 37% dos portadores de LDGCB de alto risco, sem diferença entre os subgrupos de LDGCB do CG ou de CBA.

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Modified Magrath IVAC regimen as second-line therapy for relapsed or refractory aggressive non-Hodgkin's lymphoma in developing countries: The experience of a single center in Brazil

Cited by 7 publications

References 18 publications

Ifosfamide, etoposide, cytarabine, and dexamethasone as salvage treatment followed by high‐dose cyclophosphamide, melphalan, and etoposide with autologous peripheral blood stem cell transplantation for relapsed or refractory lymphomas

Ifosfamide, etoposide, cytarabine, and dexamethasone as salvage treatment followed by high‐dose cyclophosphamide, melphalan, and etoposide with autologous peripheral blood stem cell transplantation for relapsed or refractory lymphomas

Interim fluorine-18 fluorodeoxyglucose PET-computed tomography and cell of origin by immunohistochemistry predicts progression-free and overall survival in diffuse large B-cell lymphoma patients in the rituximab era

Bcl-2 protein frequency in patients with high-risk diffuse large B-cell lymphoma

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