Combination of fludarabine and mitoxantrone in untreated stages III and IV low-grade lymphoma: S9501

William S. Velasquez, Danika Lew, Thomas M. Grogan, C. Harris Spiridonidis, Stanley P. Balcerzak, Shaker R. Dakhil, Thomas P. Miller, Keith S. Lanier, Robert A. Chapman, Richard I. Fisher

Research output: Contribution to journalArticle

50 Scopus citations

Abstract

Purpose: To determine the efficacy of combination fludarabine and mitoxantrone (FN) in untreated stages III and IV low-grade lymphoma. The major end point was to estimate progression-free survival (PFS) in all eligible patients. Patients and Methods: Seventy-eight eligible patients were registered. Chemotherapy courses were administered every 4 weeks with mitoxantrone 10 mg/m2 on day 1 and fludarabine 25 mg/m2 on days 1, 2, and 3 for a total of six to eight cycles. Pneumocystis carinii prophylaxis was required. Results: Seventy-three patients (94%) attained an objective response. Complete remission was demonstrated in 34 patients (44%) and partial remission was demonstrated in 39 patients (50%). With a median follow-up time of 5.5 years, the median PFS was 32 months, with a 4-year PFS rate of 38%. Median survival has not been reached and 88% of all patients are alive at 4 years. The application of the International Prognostic Index and serologic staging showed significant differences in PFS in all risk groups, whereas overall survival was markedly worse for the highest-risk group in either prognostic model. Three prior Southwest Oncology Group trials using a regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone or a combination of prednisone, vincristine, methotrexate, cytarabine, cyclophosphamide, etoposide, nitrogen mustard, vincristine, procarbazine, and prednisone in similar patient populations demonstrated comparable clinical outcome, although the 4-year survival for FN was better. FN was well tolerated, but mild to severe reversible myelosuppression was noted. Other complications were rare. Conclusion: FN is an effective, safe chemotherapy combination for patients with advanced-stage, low-grade lymphoma. Clinical outcomes were comparable to prior published data using anthracycline-based regimens.

Original languageEnglish (US)
Pages (from-to)1996-2003
Number of pages8
JournalJournal of Clinical Oncology
Volume21
Issue number10
DOIs
StatePublished - May 15 2003
Externally publishedYes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Fingerprint Dive into the research topics of 'Combination of fludarabine and mitoxantrone in untreated stages III and IV low-grade lymphoma: S9501'. Together they form a unique fingerprint.

  • Cite this

    Velasquez, W. S., Lew, D., Grogan, T. M., Spiridonidis, C. H., Balcerzak, S. P., Dakhil, S. R., Miller, T. P., Lanier, K. S., Chapman, R. A., & Fisher, R. I. (2003). Combination of fludarabine and mitoxantrone in untreated stages III and IV low-grade lymphoma: S9501. Journal of Clinical Oncology, 21(10), 1996-2003. https://doi.org/10.1200/JCO.2003.09.047