Abstract
Between February 1989 and February 1995,122 patients with low-grade non-Hodgkin’s lymphoma received fludarabine: 25 mg/m2 daily for 5 days, repeated every 3-4 weeks, to a maximum of eight cycles. Eighty patients received fludarabine at first or subsequent recurrence, or when the disease was deemed resistant to conventional therapy, 26 patients were treated in the context of minimal residual disease (MRD) in the bone marrow and/or lymph nodes in the hope of eventually proceeding to myeloablative therapy with autologous bone marrow transplantation. A further 16 newly diagnosed patients received fludarabine as initial therapy.
A total of 118 patients are evaluable for response. The response rate (complete remission, CR,+ partial remission, PR) in previously treated patients was 45/102 (45%) overall: 31/76 (41%) in patients with recurrent or resistant disease and 14/26 (54%) in patients with MRD. The response rate was somewhat higher in newly diagnosed patients, i.e. 11/16 (69%).
The predominant toxicity was myelosuppression, 55% and 31% of previously treated and newly diagnosed patients, respectively, requiring admission to hospital for treatment of infection. here were six treatment-related deaths (from infection), all in patients with unresponsive disease. Five patients developed unusual neurological symptoms possibly ascribable to treatment with fludarabine; four subsequently recovered fully.
These results confirm the efficacy of fludarabine in inducing regression of low-grade lymphoma and its potential toxicity.
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© 1997 Springer-Verlag Berlin Heidelberg
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Rohatiner, A.Z.S. et al. (1997). Fludarabine in Low-Grade Lymphoma: St. Bartholomew’s Hospital Experience. In: Büchner, T., Schellong, G., Ritter, J., Creutzig, U., Hiddemann, W., Wörmann, B. (eds) Acute Leukemias VI. Haematology and Blood Transfusion / Hämatologie und Bluttransfusion, vol 38. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60377-8_60
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DOI: https://doi.org/10.1007/978-3-642-60377-8_60
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