Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma

Apostolia M. Tsimberidou, Peter McLaughlin, Anas Younes, Maria A. Rodriguez, Fredrick B. Hagemeister, Andreas Sarris, Jorge Romaguera, Mark Hess, Terry L. Smith, Ying Yang, Ana Ayala, Alejandro Preti, Ming Sheng Lee, Fernando Cabanillas

Research output: Contribution to journalArticle

69 Scopus citations

Abstract

Treatment for patients with stage IV indolent lymphoma ranges from watchful waiting to intensive chemotherapy and stem cell transplantation. In this trial we compared 2 induction regimens followed by 1 year of interferon maintenance therapy. Fludarabine, mitoxantrone (Novantrone), and dexamethasone (FND) were compared with an alternating triple therapy (ATT) regimen (CHOD-Bleo, ESHAP, and NOPP). Maintenance interferon/dexamethasone was given for 1 year in both treatment arms. Endpoints were comparisons of remission rates, survival, failure-free survival (FFS), molecular response rates, and toxicities. One hundred forty-two patients with previously untreated stage IV indolent lymphoma were evaluable (73 on FND; 69 on ATT). The overall response rates were 97% for FND and 97% for ATT (P = .9). The median follow-up is 5.9 years. The 5-year survival rates were 84% with FND and 82% with ATT (P = .9); the 5-year FFS rates were 41% with FND and 50% with ATT (P = .02). In a multivariate analysis, factors predicting for longer FFS were β2-microglobulin less than 3 mg/L (P = .01) and ATT treatment (P = .03). ATT was associated with a substantially higher rate of grade 3-4 toxicities than FND. In conclusion, both regimens were associated with high rates of response and survival. ATT was associated with substantially longer FFS, but it was more toxic than FND.

Original languageEnglish (US)
Pages (from-to)4351-4357
Number of pages7
JournalBlood
Volume100
Issue number13
DOIs
StatePublished - Dec 15 2002

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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