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Article: Fludarabine, mitoxantrone and dexamethasone (FND) in the treatment of indolent lymphoid malignancies

TitleFludarabine, mitoxantrone and dexamethasone (FND) in the treatment of indolent lymphoid malignancies
Authors
Issue Date2000
PublisherAmerican Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/
Citation
Blood, 2000, v. 96 n. 11 PART II, p. 233b How to Cite?
AbstractBackground: Indolent lymphomas are uncommon in the Chinese people and optimal treatment is undefined. We evaluated prospectively the combination of fludarabine, mitoxantrone and dexamethasone (FND), a regimen shown to be effective in the West for low-grade lymphomas, in the treatment of indolent lymphomas in this population. Patients and methods: There were 44 men and 20 women, with a median age of 61 (33 -72) years. The diagnosis included follicular lymphoma (FL) (n=28), chronic B cell leukemia (B-LPD) (n=l 6), mantle cell lymphoma (MCL)(n=4), marginal zone B cell lymphoma (MZBL) (n=4), Maltoma with diffuse component (n=8), andT cell lymphoma (n=4). A total of 28 cases (43%) were treated at diagnosis (Dx) while 36 cases (57%) at relapse. The FND regimen comprised fludarabine (25mg/m2/day x3), mitoxantrone (10mg/m2xl) and dexamethasone (20mg/day x5), given at monthly intervals for six courses. This was given on an outpatient basis with cotrimoxazole prophylaxis for pneumocystis infection. Results: Sixty cases were évaluable. The overall response rate was 70% with complete response (CR) and partial response (PR) rates of 57% and 13% respectively. Therapy was not completed in 15 cases (23%) because of infection (n=8) or rapid disease progression (n=7). A high CR rate was observed in the following disease subtypes: grade 1/2 FL at Dx (10/10,100%), T cell lymphoma (3/4,75%), MZBL (3/4,75%) and Maltoma (4/6,66%). Intermediate response rates (CR+PR) were seen in grade 1/2 FL at relapse (6/9, 66%) and in B-LPD (5/11, 56%). The response rates in patients previously treated with purine analogues and anthracycline containing regimens were 60% and 55% respectively. Diseases with low response rates included grade 3 FL (I/ 3,33%), MCL (1/4,25%) and transformed B-LPD (0/3,0%) Prolonged marrow suppression and septicemia (n= 12) occurred mainly in older patients (age>65, n=5) and heavily pretreated cases (>6 courses, n=6). Opportunistic infections included tuberculosis (TB) (n=4), cytomegalovirus gastritis (n=l) and systemic cryptococcosis (n=l). Hepatitis B carriers (n=7) were given prophylactic lamivudine and no reactivation occurred. At a median follow up time of 13.8 months, disease progression was observed in 6 responding cases (5PR, 1CR). Sixteen patients have died, 13 due to disease progression, one each from sepsis, cirrhosis and bronchogenic carcinoma. Conclusions: FND appears to be a safe and effective first-line and salvage treatment in a wide spectrum of indolent lymphoproliferative disease in Chinese patients. The high response rate in T-lineage disorder is encouraging. Owing to its immunosuppressive effects, prudent prophylaxis for opportunistic infections is required.
Persistent Identifierhttp://hdl.handle.net/10722/163020
ISSN
2023 Impact Factor: 21.0
2023 SCImago Journal Rankings: 5.272

 

DC FieldValueLanguage
dc.contributor.authorAu, WYen_US
dc.contributor.authorChim, CSen_US
dc.contributor.authorLiang, Ren_US
dc.contributor.authorKwong, YLen_US
dc.date.accessioned2012-09-05T05:26:38Z-
dc.date.available2012-09-05T05:26:38Z-
dc.date.issued2000en_US
dc.identifier.citationBlood, 2000, v. 96 n. 11 PART II, p. 233ben_US
dc.identifier.issn0006-4971en_US
dc.identifier.urihttp://hdl.handle.net/10722/163020-
dc.description.abstractBackground: Indolent lymphomas are uncommon in the Chinese people and optimal treatment is undefined. We evaluated prospectively the combination of fludarabine, mitoxantrone and dexamethasone (FND), a regimen shown to be effective in the West for low-grade lymphomas, in the treatment of indolent lymphomas in this population. Patients and methods: There were 44 men and 20 women, with a median age of 61 (33 -72) years. The diagnosis included follicular lymphoma (FL) (n=28), chronic B cell leukemia (B-LPD) (n=l 6), mantle cell lymphoma (MCL)(n=4), marginal zone B cell lymphoma (MZBL) (n=4), Maltoma with diffuse component (n=8), andT cell lymphoma (n=4). A total of 28 cases (43%) were treated at diagnosis (Dx) while 36 cases (57%) at relapse. The FND regimen comprised fludarabine (25mg/m2/day x3), mitoxantrone (10mg/m2xl) and dexamethasone (20mg/day x5), given at monthly intervals for six courses. This was given on an outpatient basis with cotrimoxazole prophylaxis for pneumocystis infection. Results: Sixty cases were évaluable. The overall response rate was 70% with complete response (CR) and partial response (PR) rates of 57% and 13% respectively. Therapy was not completed in 15 cases (23%) because of infection (n=8) or rapid disease progression (n=7). A high CR rate was observed in the following disease subtypes: grade 1/2 FL at Dx (10/10,100%), T cell lymphoma (3/4,75%), MZBL (3/4,75%) and Maltoma (4/6,66%). Intermediate response rates (CR+PR) were seen in grade 1/2 FL at relapse (6/9, 66%) and in B-LPD (5/11, 56%). The response rates in patients previously treated with purine analogues and anthracycline containing regimens were 60% and 55% respectively. Diseases with low response rates included grade 3 FL (I/ 3,33%), MCL (1/4,25%) and transformed B-LPD (0/3,0%) Prolonged marrow suppression and septicemia (n= 12) occurred mainly in older patients (age>65, n=5) and heavily pretreated cases (>6 courses, n=6). Opportunistic infections included tuberculosis (TB) (n=4), cytomegalovirus gastritis (n=l) and systemic cryptococcosis (n=l). Hepatitis B carriers (n=7) were given prophylactic lamivudine and no reactivation occurred. At a median follow up time of 13.8 months, disease progression was observed in 6 responding cases (5PR, 1CR). Sixteen patients have died, 13 due to disease progression, one each from sepsis, cirrhosis and bronchogenic carcinoma. Conclusions: FND appears to be a safe and effective first-line and salvage treatment in a wide spectrum of indolent lymphoproliferative disease in Chinese patients. The high response rate in T-lineage disorder is encouraging. Owing to its immunosuppressive effects, prudent prophylaxis for opportunistic infections is required.en_US
dc.languageengen_US
dc.publisherAmerican Society of Hematology. The Journal's web site is located at http://bloodjournal.hematologylibrary.org/en_US
dc.relation.ispartofBlooden_US
dc.titleFludarabine, mitoxantrone and dexamethasone (FND) in the treatment of indolent lymphoid malignanciesen_US
dc.typeArticleen_US
dc.identifier.emailChim, CS:jcschim@hku.hken_US
dc.identifier.emailLiang, R:rliang@hku.hken_US
dc.identifier.emailKwong, YL:ylkwong@hku.hken_US
dc.identifier.authorityChim, CS=rp00408en_US
dc.identifier.authorityLiang, R=rp00345en_US
dc.identifier.authorityKwong, YL=rp00358en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.scopuseid_2-s2.0-33748570110en_US
dc.identifier.hkuros60079-
dc.identifier.volume96en_US
dc.identifier.issue11 PART IIen_US
dc.identifier.spage233ben_US
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridAu, WY=7202383089en_US
dc.identifier.scopusauthoridChim, CS=7004597253en_US
dc.identifier.scopusauthoridLiang, R=26643224900en_US
dc.identifier.scopusauthoridKwong, YL=7102818954en_US
dc.identifier.issnl0006-4971-

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