Treatment of refractory malignant lymphomas with ifosfamide/etoposide combination chemotherapy

Twenty patients with malignant lymphomas refractory to prior combination chemotherapy were treated with ifosfamide (40 mg/kg/day i.v. days 1-5) and etoposide (120 mg/m2/day i.v., days 1, 3, 5). Altogether, 56 courses of treatment were given with prophylaxis of urinary side effects by mesna (8 mg/kg i.v. 0, 4, 8 hours after ifosfamide). The overall response rate (min. 25% tumor reduction) was 14/20 (70%) including 5/8 partial remissions in patients with non-Hodgkin's lymphoma and 2/12 partial remissions in patients with Hodgkin's disease. The lower total response rate of 7/12 in patients with Hodgkin's disease in comparison to 7/8 in patients with non-Hodgkin's lymphoma may be related to the different sensitivity of both diseases or to differences in the extent and duration of prior chemotherapy. As combination chemotherapy with ifosfamide/etoposide proved to be effective in refractory malignant lymphomas this combination may be included in combination chemotherapy programs for the salvage therapy or the initial treatment of malignant lymphomas with the alternation of non-cross-resistant chemotherapy combinations.