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Annals of Hematology

, Volume 95, Issue 7, pp 1129–1136 | Cite as

High-dose ifosfamide and mitoxantrone (HDIM) in patients with relapsed or refractory Hodgkin’s lymphoma

  • Igor AurerEmail author
  • Damir Nemet
  • Zdravko Mitrović
  • Dino Dujmović
  • Sandra Bašić-Kinda
  • Ivo Radman
  • Dubravka Sertić
  • Fedor Šantek
  • Marko Kralik
  • Snježana Dotlić
  • Sanja Mazić
  • Boris Labar
Original Article

Abstract

Relapsed/refractory Hodgkin’s lymphoma (HL) is treated with salvage chemotherapy and autologous stem cell transplantation (ASCT). Optimal chemotherapy is unknown. We retrospectively analyzed outcomes of 58 patients treated with 2 cycles of high-dose ifosfamide and mitoxantrone (HDIM). HDIM consisted of ifosfamide 5 g/m2/day and MESNA 5 g/m2/day in continuous 24-h infusion (days 1 and 2), MESNA 2.5 g/m2 over 12 h (day 3), and mitoxantrone 20 mg/m2 (day 1) administered every 2 weeks. Stem cells were collected after the first cycle. Responding patients proceeded to ASCT. Toxicity was acceptable. Stem cell mobilization was successful in 96 % of patients. Overall response rate was 74 % (89 % in relapsing and 45 % in refractory patients) with 31 % complete remissions. After a median follow-up of 54 months, 5-year event-free survival was 56 % (69 % for relapsing and 35 % for refractory patients), and 5-year overall survival was 67 % (73 % for relapsing and 55 % for refractory patients). Significant adverse prognostic factors were refractoriness to previous therapy and HDIM failure. No differences in outcomes were noted between patients with early and late relapses or between complete and partial responders. HDIM is a well-tolerated and effective regimen for relapsed and refractory HL with excellent stem cell mobilizing properties. Patients failing HDIM may still benefit from other salvage options.

Keywords

Hodgkin’s lymphoma Antineoplastic combined chemotherapy protocols Ifosfamide Mitoxantrone Autologous stem cell transplantation 

Notes

Acknowledgments

Presented in part at the 8th International Symposium on Hodgkin’s Lymphoma, Cologne, Germany, 2010.

Compliance with ethical standards

Funding

Supported in part by the Croatian Ministry of Science and Education (grant number 108-1081872-1908).

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Igor Aurer
    • 1
    • 2
    Email author
  • Damir Nemet
    • 1
    • 2
  • Zdravko Mitrović
    • 2
  • Dino Dujmović
    • 2
  • Sandra Bašić-Kinda
    • 1
  • Ivo Radman
    • 1
  • Dubravka Sertić
    • 1
  • Fedor Šantek
    • 2
    • 3
  • Marko Kralik
    • 4
  • Snježana Dotlić
    • 5
  • Sanja Mazić
    • 6
  • Boris Labar
    • 1
    • 2
  1. 1.Division of Hematology, Department of Internal MedicineUniversity Hospital Centre ZagrebZagrebCroatia
  2. 2.Medical SchoolUniversity of ZagrebZagrebCroatia
  3. 3.Department of OncologyUniversity Hospital Centre ZagrebZagrebCroatia
  4. 4.Department of RadiologyUniversity Hospital Centre ZagrebZagrebCroatia
  5. 5.Department of Pathology and CytologyUniversity Hospital Centre ZagrebZagrebCroatia
  6. 6.Department of Transfusion MedicineUniversity Hospital Centre ZagrebZagrebCroatia

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