Ninety-Six-Hour Paclitaxel Infusion with Mitoxantrone and Ifosfamide/Mesna and Consolidation with ESHAP for Refractory and Relapsed Non-Hodgkin's Lymphoma

Abstract

A prospective phase II study was carried out in 48 patients with relapsed or refractory non-Hodgkin's lymphoma using paclitaxel 27.5 mg/M² IV by continuous infusion over 24 hours daily on days 1, 2, 3, and 4 in combination with mitoxantrone 8 mg/M² IV on day 1 and ifosfamide/mesna 1.33 grams/M² IV daily on days 1, 2, and 3 (MINT). Responding patients completed four cycles of MINT and were consolidated with etoposide, solumedrol [methyl-prednisolone], high-dose cytarabine [Ara-C], and platinum (ESHAP). Forty-eight patients were entered in the study between 1994 and 1996 at The University of Texas M. D. Anderson Cancer Center. Overall response after the first four cycles of MINT was 67% (16% complete response [CR]+ 51% partial response [PR]) and after consolidation with ESHAP it was 49% (26% CR + 23% PR). Variables associated with an improved CR rate and better failure-free survival included the number of prior treatments and the response to prior treatment. A comparison with a similar group of patients treated with mesna, ifosfamide, mitoxantrone, and etoposide (MINE)-ESHAP revealed no major differences in outcome.

Key Words:

• paclitaxel infusion
• mitoxantrone
• ifosfamide
• MESNA
• ESHAP
• refractory lymphoma
• refractory non-Hodgkin's lymphoma
• relapsed lymphoma