Clinical Observation of FMD Regimen: Fludarabine,Mitoxantrone, Dexamethasone, in Treatment of Non-Hodgkin's Lymphoma

Shuqing Lü, Jianmin WANG, Xianmin SONG, Li CHEN, Weiping ZHANG, Jun HOU, Xiaoqian XU, Chongmei HUANG, Jianmin YANG

Abstract


OBJECTIVE     To evaluate the clinical effectivity and toxicity of the regimen FMD ( fludarabine, mitoxantrone, dexamethasone) in patients with non-Hodgkin’s lymphoma.
METHODS     Thirty-two patients, twenty-four of whom had indolent B-cell lymphoma,   6 peripheral T-cell lymphoma, two diffuse large B-cell lymphoma, received FMD. Treatment comprised: fludarabine 25~30 mg/m2 days 1~3, mitoxantrone 8~10 mg/m2 day 1, and dexamethasone 20~30 mg /m2 days 1~5. At the same time, patients received prophylaxis against conditional infection with trimethoprim-sulfamethoxazole, fluconazole, acyclovir and immunoglobulin.
RESULTS    Of the thirty-two patients treated, the complete response (CR) rate, partial response (PR) rate and overall response (OR) rate were 56.3%, 21.9% and 78.2% respectively. The CR and OR rate of 24 patients with indolent B-cell lymphoma were 66.7% and 88.3% respectively. Two of six patients with peripheral T-cell lymphoma were of complete response type and one was of partial response type. One of two patients with diffuse large B-cell lymphoma was partial response. The dominating toxicity was myelotoxicity and immunotoxicity. There was no treatment associated death in all patients treated with FMD. Grade 3~4 neutropenia occurred in 43.8% patients, 12.5% patients had infections and 9.3% developed grade 3~4 thrombocytopenia.  At a median follow-up of 24 (5~54) months, the 2-year overall-survival rate and progression-free survival rate were (87.5 ± 1.4)% and (83.3 ± 1.6)% respectively. The 2-year OS and PFS rates of the indolent group were (93.75 ± 6.25)% and (87.5 ± 8.54)%.
CONCLUSION     FMD regimen was highly effective with low toxicity in the treatment of non-Hodgkin’s lymphoma, especially in indolent B-cell lymphoma. It also helps to improve the prognosis even in some aggressive lymphoma, such as peripheral T cell lymphoma.

Keywords


fludarabine, mitoxantrone, dexamethasone, lymphoma, non-Hodgkin’s.

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