A combination of mitoxantrone, etoposide and prednisone in elderly patients with non-Hodgkin's lymphoma.

From January 1988 to December 1991, 55 elderly patients (14 pretreated and 41 previously untreated) with non-Hodgkin's lymphoma (NHL) entered a prospective study to evaluate the feasibility of a combination of mitoxantrone (7-9 mg/m2), VP 16-213 (150 mg, 2-hour infusion on day 1, and 200 mg per os on days 3 and 5) and low-dose prednisone (25 mg days 1-5) (MVP regimen), recycling every 21-28 days. The median age was 75 (range 64-93). All but 4 pretreated patients had intermediate- or high-grade lymphomas. Complete remissions were obtained in 22 of 40 (55%) evaluable previously untreated patients, and partial remissions in 10 (2 of these obtained complete remissions after radiotherapy), for an overall response rate of 80%. The median duration of response was 12 months. At 24 months the overall survival was 52% and the relapse-free survival was 31%. Of 14 pretreated patients complete remissions were obtained in 4 (29%) and partial remissions in 3. Granulocytopenia and fever were the most important side effects; two patients contracted bronchopneumonia and one of them died. Other toxicities were mild. We conclude that this combination chemotherapy is effective as first-line and salvage treatment in elderly patients with intermediate- and high-grade NHL, and that it is feasible on an outpatient basis, with manageable toxicity.

Mitoxantrone alone or in combination chemotherapy (VeMP) as second-line treatment in relapsed or refractory poor-prognosis non-Hodgkin's lymphoma. A report of the Non-Hodgkin's Lymphoma Co-operative Study Group (NHLCSG).

BACKGROUND AND METHODS: From October, 1986 to July 1989, 35 consecutive patients with high- and intermediate-grade non-Hodgkin's lymphoma, relapsed or refractory to first-line-anthracycline-containing regimens, were treated with mitoxantrone alone or in combination chemotherapy (VeMP: Ve = VP-16, M = Mitoxantrone, P = Prednisolone). RESULTS: In the first 15 patients, treated with Mitoxantrone alone, complete response (CR) and partial response (PR) each occurred in 4 patients, for a total response rate of 54%. In the following 20 patients, treated with the VeMP regimen, CR occurred in 10 patients (50%), PR in 1. The overall three-year survival was 27% in the first group and 40% in the second. Acute toxicity was generally mild. No patient developed cardiac symptoms or other toxicities requiring discontinuation of therapy. Myelosuppression was the most important side effect, being more remarkable for patients treated with VeMP regimen. CONCLUSION: Mitoxantrone, alone or in combination chemotherapy, appears to be a drug with significant activity in aggressive non-Hodgkin's lymphomas.

[Preventive role of pirenzepine in gastric damage during cytostatic therapy. A controlled randomized double-blind study with placebo]. / Ruolo preventivo della pirenzepina nel danno gastrico in corso di terapia citostatica. Studio in doppio cieco randomizzato controllato con placebo.

Steroids and cytostatic drugs have an undoubtedly damaging action on the gastroduodenal mucosa. The action of pirenzepine was compared with that of the placebo in preventing the gastroduodenal lesions brought on by antiblastic therapy. Sixty patients were separated into two random group under double blind conditions and received 100 mg/die/os of pirenzepine or equivalent placebo for a continuous period of 12 weeks. Antiblastic drugs were administered at the same time. Final endoscopic control and symptomatological findings showed a statistically significant different in favour of the pirenzepine-treated group as early as the 6th week of treatment. No side-effects attributable to pirenzepine were reported.