Jones L, Cotter F E, Lord D, Newland A C
Department of Haematology, London Hospital, Whitechapel, U.K.
Hematol Oncol. 1990 Jan-Feb;8(1):41-5. doi: 10.1002/hon.2900080106.
Thirty-six patients with non-Hodgkin's lymphoma (NHL) (comprising patients with refractory or relapsed disease and eight elderly, unfit patients with de novo disease) were treated with mitozantrone, chlorambucil and prednisolone on an out-patient basis. Fifteen patients had low grade (LG) disease, five patients intermediate grade (IG) disease and 16 patients high grade (HG) disease and 31/36 had stage IV disease. All elderly patients had IG or HG disease. The regimen was well-tolerated. After six courses of chemotherapy, there was a 69 per cent response rate with 33 per cent in complete remission. The median duration of remission was 15 months. The overall 3-year projected survival was 38 per cent; 27 per cent for LG disease and 47 per cent for HG and IG disease. Responses did not appear durable for either HG or LG disease unless CR was achieved early on. Three of the eight patients treated de novo (mean age 71 years) have survived disease-free, between 28 and 38 months from entry. This study indicates that mitozantrone-based regimens have promising activity in NHL and require further evaluation. The low toxicity combined with worthwhile remissions make this an attractive first-line option for elderly patients.
36例非霍奇金淋巴瘤（NHL）患者（包括难治性或复发性疾病患者以及8例初治的老年体弱患者）在门诊接受了米托蒽醌、苯丁酸氮芥和泼尼松龙治疗。15例患者为低级别（LG）疾病，5例为中级别（IG）疾病，16例为高级别（HG）疾病，36例中有31例为IV期疾病。所有老年患者均为IG或HG疾病。该方案耐受性良好。化疗六个疗程后，缓解率为69%，完全缓解率为33%。缓解期的中位数为15个月。预计3年总生存率为38%；LG疾病为27%，HG和IG疾病为47%。除非早期达到完全缓解（CR），否则HG或LG疾病的缓解似乎都不持久。8例初治患者（平均年龄71岁）中有3例无病存活，自入组起28至38个月。本研究表明，基于米托蒽醌的方案在NHL中具有有前景的活性，需要进一步评估。低毒性加上有价值的缓解使其成为老年患者有吸引力的一线选择。
