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FLUDAP: salvage chemotherapy for relapsed/refractory aggressive non-Hodgkin's lymphoma

FLUDAP: salvage chemotherapy for relapsed/refractory aggressive non-Hodgkin's lymphoma
FLUDAP: salvage chemotherapy for relapsed/refractory aggressive non-Hodgkin's lymphoma
The aim of this study was to investigate the combination of fludarabine phosphate, dexamethasone, cytosine arabinoside and cis-platinum (FLUDAP) in the treatment of patients with relapsed/refractory aggressive non-Hodgkin's lymphoma (NHL). This regimen comprises: dexamethasone 100 mg/d continuous infusion (cont. inf.) d1-3; cytosine arabinoside (ara-C) 1 g/m2/d cont. inf. d 2,3; fludarabine phosphate 30 mg/m2 short inf. 4hr prior to each 24hr ara-C inf.; cis-platinum 50 mg/m2 4hr inf. at the start of each 24hr ara-C inf. G-CSF (lenograstim, Granocyte) is given at 263 microg s.c. daily from day 7 until the neutrophil count reaches 1.0x10(9)/l. The regimen repeats at 21 day intervals. A total of 33 patients were registered (median age 47 years; 24 males, 9 females); the majority (73%) were refractory to their previous treatment and most had advanced disease by Ann Arbor stage. Thirteen (39%) of the 33 enrolled patients (52% of the 25 fully evaluable patients who received at least 2 courses of FLUDAP) responded to treatment. A maximum response of complete remission was achieved in 5 patients, good partial remission in 3, and partial remission in 5. Twelve patients went on to successful stem cell supported intensification therapy. Median survival times were higher in the responding patients, and in those patients transplanted post-FLUDAP. The toxicity associated with the FLUDAP regimen was generally predictable; frequently reported severe events included haematological toxicity and infection. In conclusion, the FLUDAP regimen shows promise as a salvage regimen and increases the available therapeutic options in the treatment of recurrent/refractory aggressive NHL.
309-317
Child, J. A.
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Johnson, S. A.
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Rule, S.
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Smith, G. M.
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Morgan, G. J.
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Johnson, Peter W.M.
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Prentice, A. G.
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Tollerfield, S. M.
fc4b3334-440f-4d9e-8069-df95cd59383a
Wareham, E.
383f7f0d-4c64-4fec-953e-7db67148e09e
Child, J. A.
9ca05a85-6e86-40b0-83e7-2c2afe5c20f5
Johnson, S. A.
9de1ccf6-5362-4232-8d3f-03160ff5c71e
Rule, S.
1885f0ee-5df7-4dd5-be9e-efebbd5ff680
Smith, G. M.
16f44588-dc46-443f-b23f-c6aaf872e220
Morgan, G. J.
2eacfa78-f9fd-4216-9c50-04a3809ecd9e
Johnson, Peter W.M.
3f6068ce-171e-4c2c-aca9-dc9b6a37413f
Prentice, A. G.
9c52ddbe-ef0b-45b6-851b-54f67909a6a4
Tollerfield, S. M.
fc4b3334-440f-4d9e-8069-df95cd59383a
Wareham, E.
383f7f0d-4c64-4fec-953e-7db67148e09e

Child, J. A., Johnson, S. A., Rule, S., Smith, G. M., Morgan, G. J., Johnson, Peter W.M., Prentice, A. G., Tollerfield, S. M. and Wareham, E. (2000) FLUDAP: salvage chemotherapy for relapsed/refractory aggressive non-Hodgkin's lymphoma. Leukemia & Lymphoma, 37 (3-4), 309-317. (doi:10.3109/10428190009089431).

Record type: Article

Abstract

The aim of this study was to investigate the combination of fludarabine phosphate, dexamethasone, cytosine arabinoside and cis-platinum (FLUDAP) in the treatment of patients with relapsed/refractory aggressive non-Hodgkin's lymphoma (NHL). This regimen comprises: dexamethasone 100 mg/d continuous infusion (cont. inf.) d1-3; cytosine arabinoside (ara-C) 1 g/m2/d cont. inf. d 2,3; fludarabine phosphate 30 mg/m2 short inf. 4hr prior to each 24hr ara-C inf.; cis-platinum 50 mg/m2 4hr inf. at the start of each 24hr ara-C inf. G-CSF (lenograstim, Granocyte) is given at 263 microg s.c. daily from day 7 until the neutrophil count reaches 1.0x10(9)/l. The regimen repeats at 21 day intervals. A total of 33 patients were registered (median age 47 years; 24 males, 9 females); the majority (73%) were refractory to their previous treatment and most had advanced disease by Ann Arbor stage. Thirteen (39%) of the 33 enrolled patients (52% of the 25 fully evaluable patients who received at least 2 courses of FLUDAP) responded to treatment. A maximum response of complete remission was achieved in 5 patients, good partial remission in 3, and partial remission in 5. Twelve patients went on to successful stem cell supported intensification therapy. Median survival times were higher in the responding patients, and in those patients transplanted post-FLUDAP. The toxicity associated with the FLUDAP regimen was generally predictable; frequently reported severe events included haematological toxicity and infection. In conclusion, the FLUDAP regimen shows promise as a salvage regimen and increases the available therapeutic options in the treatment of recurrent/refractory aggressive NHL.

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Published date: April 2000

Identifiers

Local EPrints ID: 157829
URI: http://eprints.soton.ac.uk/id/eprint/157829
PURE UUID: 223e0db4-1538-491c-aced-4bf331a6b699
ORCID for Peter W.M. Johnson: ORCID iD orcid.org/0000-0003-2306-4974

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Date deposited: 16 Jun 2010 13:47
Last modified: 20 Mar 2020 01:26

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Contributors

Author: J. A. Child
Author: S. A. Johnson
Author: S. Rule
Author: G. M. Smith
Author: G. J. Morgan
Author: A. G. Prentice
Author: S. M. Tollerfield
Author: E. Wareham

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