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.
Similar content being viewed by others
References
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
Binet JL, Leporrier M, Dighiero G, et al. (1977) A clinical staging system for chronic lymphocytic leukemia. Prognostic significance. Cancer 40: 855–864
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
Editorial (1988) Updated Kiel Classification. Lancet 1: 603–613
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
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
Hakansson L, Könyves I, Lindberg LG, et al. (1978) Continuous treatment of non-Hodgkin's malignant lymphoma with prednimustine (Leo 1031). Oncology 35: 103
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
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
Horning SJ, Rosenberg SA (1984) The natural history of initially untreated low-grade non-Hodgkin's lymphomas. N Engl J Med 311: 1471–1475
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
Kantarjian HM, Alexanian R, Koller CA, Kurzrock R, Keating MJ (1990) Fludarabine therapy in macroglobulinemic lymphoma. Blood 75: 1928–1931
Kaplan EL, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Statist Assoc 53: 457–457
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
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
Klener P, Haber J (1985) Value of prednimustine in treating non-Hodgkin's lymphomas of favourable histological type. Folia Haematol (Leipz) 112: 103–108
Landys KE (1988) Mitoxantrone in combination with prednimustine in treatment of unfavourable non-Hodgkin's lymphoma. Invest New Drugs 6: 105–113
Miller AB, Hoogstraten B, Staquet M, Winkler A (1981) Reporting results of cancer treatment. Cancer 47: 207–214
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
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
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
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
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
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01715350