Autologous Bone Marrow Transplantation - Blog Science Connections

324 Proposed International Adult Lymphoma Study
show in Figure 11 the survival curves of the MIME patients according to their
histological subtype. These curves are almost identical to those from
previous experience with 1MVP-16-213 (ifosfamide, methotrexate, etoposide)
and AIVP-16-213 (doxorubicin, ifosfamide, etoposide) for both the aggressive
and the indolent disease types.
We used MIME to treat diffuse large cell lymphoma in patients less than
60 years of age who had no bone marrow involvement: 52 patients have been
treated who meet these criteria. Twenty-two achieved a CR (42%), 13
achieved a PR (overall response rate, 67%), and 17 did not respond. There are
three long-term survivors at 46+, 26+, and 12+ months. The median survival
of this group is 40 weeks (Fig 11).
The toxicity for patients on MIME was acceptable in most instances.
However, despite good results—the best ever reported in relapse of non-
Hodgkin's lymphoma—and low toxicity, mitoguazone and ifosfamide, which
were available for this study, are no longer available for use in the United
States. Furthermore, since the completion of the MIME studies, many
patients now receive etoposide as primary therapy. A program with
nonexperimental drugs, possibly drugs non-cross-resistant to primary therapy
having response rates equal to those associated with MIME would be
desirable for reinduction therapy.
DHAP Results
Previous experience with either cisplatin or high-dose cytarabine shows
response rates of approximately 20%, practically all of the patients being in PR
Figure 11. Survival of patients treated with the MIME (mitoguazone, ifosfamide, methotrexate,
etoposide) salvage regimen according to histological subtype compared with that
of controls treated with other ifosfamide-etoposide combination regimens.