Low dose continuous chemotherapy (LD56): an active treatment with low toxicity for patients with recurrent/refractory lymphoma not eligible for intensive salvage therapy

摘要

Although a proportion of patients with Hodgkin (HL) and non-Hodgkin Lymphoma (NHL) can be cured with first-line therapy, a considerable percentage have refractory/relapsed disease (Canellos, 2007; Bartlett, 2008). High-dose therapy (HDT) with autologous stem cell support can be effective (Linch et al, 1993; Philip et al, 1995; Rohatiner, 2002), but in patients who fail to respond to second-line treatment and those unfit for intensive chemotherapy, palliative therapy should be considered to alleviate symptoms and improve quality of life (Haim et al, 1995;Helsing, 1997;Hoskin, 1997;Colemanei: al, 2008). A 'low-dose' regimen (LD-56), comprising bleomycin, vinblastine, lomustine, chlorambucil and dexamethasone was designed at St Bartholomew's Hospital for patients who had developed recurrence of HL after HDT. Following demonstration of activity (Shamash et al, 2000) its use was continued and extended to patients with other histological subtypes of lymphoma.