Clinical Observation of FMD Regimen:Fludarabine,Mitoxantrone, Dexamethasone, in Treatment of Non-Hod

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OBJECTIVE To evaluate the clinical effectivity and toxicity of the regimen FMD (fludarabine, mitoxantrone, dexamethasone)in patients with non-Hodgkins 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/m2day 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-Hodgkins lymphoma, especially in indolent B-cell lymphoma. It also helps to improve the prognosm even in some aggressive lymphoma, such as peripheral T cell lymphoma.
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