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Prednimustine and mitoxantrone (PmM) in patients with low-grade malignant non-Hodgkin's lymphoma (NHL), chronic lymphocytic leukemia (CLL), and prolymphocytic leukemia (PLL)

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Summary

Thirty-five patients with a mean age of 60.6 years (44–78 years, 22 male, 13 female) with advanced low-grade non-Hodgkin's lymphoma (NHL), chronic lymphocytic leukemia (CLL), or prolymphocytic leukemia (PLL) were treated every 4 weeks with prednimustine 100 mg/m2 p.o. d 1-d 5 and mitoxantrone 8 mg/m2 i.v. d 1 and d 2. Seven patients had CLL, one lymphocytic NHL, two PLL, 13 immunocytoma, nine centroblastic/ centrocytic NHL, and three centrocytic NHL. Twentyfive patients were pretreated. The subjective toxicity of the treatment was mild, with no WHO grade-3 alopecia, polyneuropathy, cardiotoxicity, mucositis, nausea, or vomiting. Hematologic side effects with WHO grade-4 granulopenia and thrombopenia were experienced by 26% and 23% of the patients, respectively. The overall response rate (CR + PR) was 72% for lymphoma patients and 37% for CLL patients, with a median remission duration of 14.6 months. The maximum response was achieved after a median of two treatment courses. Prednimustine with mitoxantrone is a subjectively well tolerated treatment for low-grade malignant NHL, to be further evaluated in phase-III studies. The regimen may shorten the duration of treatment, saving time-consuming outpatient visits and costs.

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References

  1. Al Ismail SA, Whittaker JA, Gough J (1987) Combination chemotherapy including epirubicin for the management of non-Hodgkin's lymphoma. Eur J Cancer Clin Oncol 23: 1379–1384

    PubMed  Google Scholar 

  2. Binet JL, Leporrier M, Dighiero G, et al. (1977) A clinical staging system for chronic lymphocytic leukemia. Prognostic significance. Cancer 40: 855–864

    PubMed  Google Scholar 

  3. Cavallin-Stahl E, Möller TR (1986) Prednimustine v cyclophosphamide-vincristine-prednisolone in the treatment of non-Hodgkin's lymphoma with favorable histopathology: results of a national cancer care program in Sweden. Semin Oncol 13: 19–22

    PubMed  Google Scholar 

  4. Editorial (1988) Updated Kiel Classification. Lancet 1: 603–613

  5. Foss Abrahamsen A, Lenner P, Hedenus M, Landys K, Noppa H (1987) Mitoxantrone in the treatment of patients with non-Hodgkin's lymphoma. Cancer Treat Rep 71: 1209–1212

    PubMed  Google Scholar 

  6. Gandara DR, Wold HG, Redmanod J, Kohler M, Reynolds R, Wong P, Forsythe J, Fisher K, Lewis B (1986) Prednimustine in refractory non-Hodgkin's lymphoma: a phase-II study of the Northern California Oncology Group. Semin Oncol 13 [Suppl 1]: 14–18

    PubMed  Google Scholar 

  7. Hakansson L, Könyves I, Lindberg LG, et al. (1978) Continuous treatment of non-Hodgkin's malignant lymphoma with prednimustine (Leo 1031). Oncology 35: 103

    PubMed  Google Scholar 

  8. Heim ME, Fritze D, Ho AD, Mebes W, Abel U (1987) Phase-III-Studie zur Chemotherapie niedrig-maligner Non-Hodgkin-Lymphome: Vergleich einer Vincristin- mit einer Vindesin-Kombinations-Chemotherapie. Onkologie 10: 345–348

    PubMed  Google Scholar 

  9. Hiddemann W, Unterhalt M, Koch P, Nahler M, van de Loo J (1990) Treatment of low-grade non-Hodgkin's lymphoma by cytoreductive chemotherapy with prednimustine/mitoxantrone followed by interferon α-2b maintenance: results of a clinical phase-II study. Semin Oncol 17: 20–23

    Google Scholar 

  10. Horning SJ, Rosenberg SA (1984) The natural history of initially untreated low-grade non-Hodgkin's lymphomas. N Engl J Med 311: 1471–1475

    PubMed  Google Scholar 

  11. Ideström K, Kimby E, Björkholm M, Mellstedt H, Enstedt L, Gahrton G, Johansson B, Killander D, Robérts K-H, Stalfelt A-M, Udén A-M, Wadman B, Wählby S (1982) Treatment of chronic lymphocytic leukaemia and well-differentiated lymphocytic lymphoma with continuous low- or intermittent highdose prednimustine versus chlorambucil/prednisolone. Eur J Cancer 14: 1117–1123

    Google Scholar 

  12. Kantarjian HM, Alexanian R, Koller CA, Kurzrock R, Keating MJ (1990) Fludarabine therapy in macroglobulinemic lymphoma. Blood 75: 1928–1931

    PubMed  Google Scholar 

  13. Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Statist Assoc 53: 457–457

    Google Scholar 

  14. Kaufman JH, Hanjura GL, Mittelman A, et al. (1976) Study of Leo-1031 (NSC-134087) in lymphocytic lymphoma and chronic lymphocytic leukemia. Cancer Treat Rep 60: 277

    PubMed  Google Scholar 

  15. Keating MJ, Kantarjian H, Talpaz M, Redman J, Koller C, Barlogie B, Velasquez W, Plunkett W, Freireich EJ, McCredie KB (1989) Fludarabine: a new agent with major activity against chronic lymphocytic leukemia. Blood 74: 19–25

    PubMed  Google Scholar 

  16. Klener P, Haber J (1985) Value of prednimustine in treating non-Hodgkin's lymphomas of favourable histological type. Folia Haematol (Leipz) 112: 103–108

    Google Scholar 

  17. Landys KE (1988) Mitoxantrone in combination with prednimustine in treatment of unfavourable non-Hodgkin's lymphoma. Invest New Drugs 6: 105–113

    PubMed  Google Scholar 

  18. Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47: 207–214

    PubMed  Google Scholar 

  19. Pedersen-Bjergard J, Mork Hansen J, Geisler CH, et al. (1980) Clinical trial of prednimustine, Leo-1031 (NSC-134087), in patients with non-Hodgkin's lymphomata and chronic lymphocytic leukemia previously treated with steroids and alkylating agents. Acta Med Scand 207: 215

    PubMed  Google Scholar 

  20. Steward WP, Crowther D, McWilliam LJ, Jones JM, Deakin DP, Todd ID, Blackledge G, Wagstaff J, Scarffe JH, Harris M (1988) Maintenance chlorambucil after CVP in the management of advanced stage, low-grade histologic type non-Hodgkin's lymphoma. A randomized prospective study with an assessment of prognostic factors. Cancer 61: 441–447

    PubMed  Google Scholar 

  21. Whelan JS, Davis CL, Rule S, Ranson M, Smith OP, Mehta AB, Catovsky D, Rohatiner AZ, Lister TA (1991) Fludarabine phosphate for the treatment of low-grade lymphoid malignancy. Br J Cancer 64: 120–123

    PubMed  Google Scholar 

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Freund, M., Wunsch-Zeddies, S., Schäfers, M. et al. Prednimustine and mitoxantrone (PmM) in patients with low-grade malignant non-Hodgkin's lymphoma (NHL), chronic lymphocytic leukemia (CLL), and prolymphocytic leukemia (PLL). Ann Hematol 64, 83–87 (1992). https://doi.org/10.1007/BF01715350

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  • DOI: https://doi.org/10.1007/BF01715350

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