High Dose Ifosfamide in Combination with Etoposide and Epirubicin Followed by Autologous Stem Cell Transplantation in the Treatment of Relapsecd/Refractory Hodgkin's Disease: a Report on Toxicity and Efficacy On behalf of the Scotland and Newcastle Lymphoma Group

Patients with Hodgkin's disease (HD) refractory to first line chemotherapy and those who have rapid or multiple relapses have a very poor prognosis. With the increasing use of hybrid chemotherapy these patients will have been exposed to many of the drugs active in HD so it is important to develop salvage regimens that are novel and demonstrate activity in this group of patients. We report the use of a continuous high dose infusion of 'ifosfamide at a dose of 9g/m2 over 3 days in combination with etoposide and epirubicin followed by autologous stem cell transplant with either BEAM or Melphalan/VP16 conditioning in this difficult group. Forty six patients (28M18F) with a median age of 28 years (range 13–45) were treated. Overall 39 out of 46 (85%) patients responded to treatment, with 17 achieving complete remission and 11 a good partial remission; 28 proceeded to autologous bone marrow/stem cell transplantation. In total, 23 patients are alive and in continuous remission with a follow up of between 12 and ...