Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:Q06643 (non-Hodgkin's lymphoma)
 11,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Curability of patients with advanced intermediate- or high-grade non-Hodgkin's lymphoma using front-line anthracycline-containing chemotherapy remains disappointingly low. Novel regimens used as salvage therapy for these patients continue to be explored. Ifosfamide has been shown to have significant single-agent activity against non-Hodgkin's lymphoma and its use in various combinations produces response rates of 20% to 83% in patients with refractory or relapsing disease. In our study of 32 evaluable patients using dexamethasone/ifosfamide/cisplatin/etoposide as salvage treatment, seven patients (22%) achieved a complete response and 15 (47%) had a partial response, for an overall response rate of 69%. Median duration of response is substantial for patients who achieve a complete response (18+ months), and dexamethasone/ifosfamide/cisplatin/etoposide produces useful palliation in some patients who attain a partial response (16+ months). Gastrointestinal side effects are minimal, with myelosuppression being the dose-limiting toxicity. Ifosfamide-containing regimens have now been incorporated either as response-adapted consolidation to front-line therapy or integrated with standard front-line treatment. We have divided our patient population by age and are investigating prednisone/etoposide/mitoxantrone as front-line therapy for patients older than 65 years. Patients younger than 65 are now being entered into a front-line, response-adapted, ifosfamide-containing chemotherapy regimen with a view to enhancing their curability.
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PMID:New perspectives in the treatment of non-Hodgkin's lymphoma. 148 71

Ifosfamide (2.0 g/m2 intravenously/day x 3) with mesna (400 mg/m2 intravenously q 4 h daily x 3) was combined with mitoxantrone (14 mg/m2 intravenously x 1) and given on a 3 week schedule to patients with previously treated non-Hodgkin's lymphoma. In 45 eligible/evaluable patients, a 47% response rate (95% confidence interval: 32%, 62%) was achieved of which 25% were complete responses and 22% were partial responses. Median duration of remission was 10 months with 42% of patients in remission at 18 months. Hematologic toxicity (granulocytopenia) was the dose-limiting toxicity with severe or life-threatening granulocytopenia in 98% of patients at full protocol doses. Nausea/vomiting was seen in 73% of patients but was usually mild/moderate. Three patients had significant hematuria secondary to ifosfamide. Two patients had severe changes in the left ventricular ejection fraction (LVEF) secondary to mitoxantrone; and one patient had acute neurologic dysfunction secondary to ifosfamide. Ifosfamide/mesna can be safely combined with mitoxantrone at full doses in previously treated patients with non-Hodgkin's lymphoma. This combination should be considered for other trials in lymphoma.
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PMID:Phase II trial of ifosfamide/mesna and mitoxantrone in previously treated patients with non-Hodgkin's lymphoma: cancer and leukemia group B study 8753. 160 55

Ifosfamide (1.25 g/m2 intravenously/day x 5) with mesna (20 per cent of the ifosfamide dose x six doses on each day of ifosfamide therapy) was administered to 46 previously treated patients with non-Hodgkin's lymphoma of which 31 were eligible and evaluable. A 29 per cent response rate (9/31) was observed (two CR and seven PR) with a median duration of response of 2.5 months. Myelosuppression was dose-limiting. Hemorrhagic cystitis was observed in three patients (10 per cent). Nausea and vomiting was generally mild or moderate. One patient developed transient neurotoxic symptoms with confusion and disorientation. An additional patient developed an anaphylactic-type reaction with shortness of breath and respiratory stridor during the fourth course of therapy. Ifosfamide, as a single agent, produces remissions of limited duration in non-Hodgkin's lymphoma in patients in second or third relapse.
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PMID:Phase II trial of ifosfamide and mesna in previously treated patients with non-Hodgkin's lymphoma: Cancer and Leukemia Group B study 8552. 174 22

Ifosfamide (1.25 g/m2 intravenously/day x 5) with mesna (20% of the ifosfamide dose x six doses on each day of ifosfamide therapy) was administered to 46 previously treated patients with non-Hodgkin's lymphoma of which 31 were eligible and evaluable. A 29% response rate (9/31) was observed (2 CR and 7 PR) with a median duration of response of 2.5 months. Myelosuppression was dose-limiting. Hemorrhagic cystitis was observed in three patients (10%). Nausea and vomiting was generally mild or moderate. One patient developed transient neurotoxic symptoms with confusion and disorientation. An additional patient developed an anaphylactic-type reaction with shortness of breath and respiratory strider during the fourth course of therapy. Ifosfamide, as a single agent, produces remissions of limited duration in non-Hodgkin's lymphoma in patients in second or third relapse.
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PMID:Phase II trial of ifosfamide and mesna in previously treated patients with non-Hodgkin's lymphoma: Cancer and Leukemia Group B Study 8552. 313 91

Ifosfamide has been used extensively for the treatment of patients with non-Hodgkin's lymphoma (NHL). This review is limited to published series in which 30 or more evaluable patients were treated in a prospective, uniform fashion either with ifosfamide alone or in combination with other chemotherapeutic agents. Studies in which ifosfamide was used solely as part of a high-dose chemotherapy preparative regimen with autologous hematopoietic progenitor cell transplantation are not included. Three different applications of ifosfamide are addressed: (1) ifosfamide as a single agent and in combination chemotherapy for patients with previously treated NHL, (2) ifosfamide in combination chemotherapy for patients with newly diagnosed, aggressive NHL; and (3) ifosfamide in combination chemotherapy as consolidation for patients with aggressive NHL in first complete remission.
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PMID:Ifosfamide in the treatment of non-Hodgkin's lymphoma. 867 45

Patients with non-Hodgkin's lymphoma (NHL) who either fail to achieve or relapse following an initial complete remission have a poor prognosis with conventional salvage chemotherapy. Patients with chemotherapy-sensitive NHL have a 45% chance of long-term disease-free survival with high-dose chemotherapy and autologous bone marrow transplantation (ABMT). Patients with chemotherapy-resistant NHL have a significantly reduced chance of long-term disease-free survival. Ifosfamide, a synthetic analogue of cyclophosphamide, has been evaluated in a few small trials of high-dose chemotherapy and ABMT in lymphoma. Because of their clinical synergy, ifosfamide has been combined with carboplatin and etoposide (ICE) and given with ABMT in several phase I/II dose-escalating studies. Maximum tolerated doses of the ICE regimen in these trials are 16 to 20.1 g/m2 ifosfamide, 1.8 g/m2 carboplatin, and 1.2 to 3.0 g/m2 etoposide. Renal, central nervous system, and cardiac toxicities have precluded further dose escalation. Sequential dosing protocols, administration of high-dose chemotherapy with peripheral blood progenitor cell support, and other approaches, possibly combining current treatment options, may be necessary to further improve the long-term survival of patients with relapsed NHL.
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PMID:Dose-intensive ifosfamide for the treatment of non-Hodgkin's lymphoma. 867 46

Currently, approximately 50% of patients with non-Hodgkin's lymphoma are eventually cured. Most patients who are cured reach a complete response after first-line chemotherapy, but a meaningful number of patients with partial response and those whose treatment fails or whose disease relapses can achieve a durable disease-free remission with effective salvage therapy. This usually involves multidrug intensive chemotherapy with or without bone marrow transplantation. Ifosfamide, an active drug in this setting, is a component of many of these salvage regimens. Some results with the combination of ifosfamide/etoposide, sometimes combined with mitoxantrone and/or cytarabine, are presented. Many relapsing lymphoma patients will require additional treatment after salvage chemotherapy, such as high-dose therapy with bone marrow transplantation, to realize a better long-term outcome.
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PMID:Ifosfamide in the treatment of lymphoma. 871 98

Several trials of new salvage therapies for relapsed and refractory non-Hodgkin's lymphoma are based on ifosfamide and paclitaxel. These programs variably Induce clinical remissions and prepare patients for stem cell and bone marrow transplantations. Ifosfamide-containing regimens are also being evaluated in the treatment of newly diagnosed patients. However, no data exist with regard to paclitaxel-containing regimens outside salvage settings. This report reviews the effects of these compounds in the treatment of relapsed and refractory non-Hodgkin's lymphoma and proposes likely directions for future study.
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PMID:Ifosfamide- and paclitaxel-based treatment of relapsed and refractory lymphoma. 1069 39

Ifosfamide is an alkylating agent with proven efficacy in the treatment of solid tumours and malignant lymphomas. Because it causes only mild to moderate myelosuppression, ifosfamide is often used in combination regimens with other agents. Ifosfamide has been mainly used in therapy of lymphoma as a component of salvage regimens, but high-dose ifosfamide is also effective in the mobilization of peripheral stem cells for treatment of patients with relapsed or refractory lymphoma with regimens containing autologous stem cell transplantation. Based on promising data with a new combination regimen containing idarubicin, etoposide and ifosfamide (IIVP-16) in patients with poor-risk non-Hodgkin's lymphoma, we have performed a phase II study using DIZE (dexamethasone 20 mg i.v. days 1-4, idarubicin 8 mg/m2 i.v. days 1 + 2, ifosfamide 1.0 g/m2 continuous infusion (c.i.) days 1-4, and etoposide 160 mg/m2 c.i. days 1-4) in patients with relapsed or refractory Hodgkin's and non-Hodgkin's lymphoma. In 43 evaluable patients, the response rate was 58%, including 11 complete remissions (CR) and 14 partial remissions (PR). The mean duration of response was 8 months (1-30). Myelosuppression was generally mild with mean duration of neutropenia < 1000/microL of 2.5 days (range 0-18) and thrombocytopenia < 25,000/microL of 1.5 days (0-17). Thus, DIZE is an effective and safe regimen for pretreated patients with aggressive lymphoma. These results appear to compare favourably with other salvage regimens such as IMVP-16 or DHAP. In conclusion, salvage regimens containing ifosfamide can play an important role in patients who are not eligible for high-dose chemotherapies. Moreover, ifosfamide might also have a role in reducing tumour burden and selecting those patients who qualify for HDCT.
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PMID:The role of ifosfamide in the treatment of relapsed and refractory lymphoma. 1148

The prognosis is poor for patients relapsing following treatment with standard chemotherapy for aggressive non-Hodgkin's lymphoma. High-dose therapy and autologous stem cell transplantation is a potential curative approach for these patients. The primary aim of second-line therapy is the attainment of a complete response, because response rate is predictive of outcome following autologous stem cell transplantation. A number of strategies have been explored to improve the complete response rate to standard second-line regimens. Ifosfamide, carboplatin, and etoposide (ICE) can offer an improved response rate compared with the standard regimens of dexamethasone, cisplatin, and cytarabine (DHAP) and etoposide, methylprednisolone, high-dose cytarabine, and cisplatin (ESHAP). The addition of rituximab to ICE improves the complete response rate compared with ICE alone. Because the addition of rituximab to chemotherapy regimens leads to improved complete response rates compared with chemotherapy alone, it should be considered as an important component of second-line regimens for aggressive NHL.
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PMID:Improving second-line therapy in aggressive non-Hodgkin's lymphoma. 1504 29


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