fludarabine, cyclophosphamide, and dexamethasone (flucyd) combination is effective in pretreated low-grade non-hodgkin's lymphoma.

NLM AIDSLINE Fludarabine, cyclophosphamide, and dexamethasone (FluCyD) combination is effective in pretreated low-grade non-Hodgkin's lymphoma. Lazzarino M; Orlandi E; Montillo M; Tedeschi A; Pagnucco G; Astori C;
July 30, 1999

Ann Oncol. 1999 Jan;10(1):59-64. Unique Identifier : AIDSLINE PURPOSE: Fludarabine phosphate is effective as a single agent in low-grade non-Hodgkin's lymphoma (NHL). Combined with other antineoplastic agents it enhances the antitumor effect. Our aim was to define the therapeutic efficacy and toxicity of a combination of fludarabine, cyclophosphamide and dexamethasone (FluCyD) in patients with advanced low-grade lymphoma. PATIENTS AND METHODS: Twenty-five adults with pretreated advanced-stage low-grade NHL were treated with three-day courses of fludarabine 25 mg/m2/day, cyclophosphamide 350 mg/m2/day, and dexamethasone 20 mg/day, every four weeks for a maximum of six courses. RESULTS: Of the 25 patients, 18 (72%) responded, 8 (32%) achieving CR and 10 (40%) PR. Seven were failures. The median follow-up was 21 months (5-26). Eight CR patients remain in CR after 5-21 months. Of 10 PR patients, 3 are in continuous PR without further treatment after 12, 17 and 18 months. Myelosuppression was the most prevalent toxic effect. Although severe granulocytopenia (granulocyte count nadir < 500/microliter) and thrombocytopenia (platelet count nadir < 50,000/microliter) occurred in only 10% and 16% of courses, respectively, slow granulocyte or platelet count recovery caused delay of 40% of the courses. Nine patients (36%) required discontinuation of therapy because of persistent granulocytopenia and/or thrombocytopenia: three after one course, three after 2-4 courses, and three after five courses. Thirteen infectious episodes in 11 patients complicated 11% of courses. Two of 10 patients monitored for the circulating EBV load showed increased viral load. One of these developed aggressive lymphoma. CD4+ lymphocytes declined from a pre-therapy median value of 425/microliter to 141/microliter post-treatment (P = 0.001). Non-hematologic toxicities were rare and mild. CONCLUSIONS: The combination of fludarabine with cyclophosphamide and dexamethasone is effective in pretreated advanced-stage low-grade NHL. It may broaden the range of therapeutic options in the salvage treatment of these patients. The main toxicity of this combination is prolonged myelosuppression that may cause treatment delay or withdrawal. The benefit of adding granulocyte colony-stimulating factor, particularly in patients with poor marrow reserve, needs to be investigated. CLINICAL TRIAL CLINICAL TRIAL, PHASE II JOURNAL ARTICLE Adult Aged Antineoplastic Agents, Alkylating/ADMINISTRATION & DOSAGE Antineoplastic Agents, Combined/ADVERSE EFFECTS/THERAPEUTIC USE Antineoplastic Agents, Hormonal/ADMINISTRATION & DOSAGE Biopsy Cyclophosphamide/ADMINISTRATION & DOSAGE CD4 Lymphocyte Count/DRUG EFFECTS Dexamethasone/ADMINISTRATION & DOSAGE Disease-Free Survival Female Human Lymph Nodes/PATHOLOGY Lymphoma, Low-Grade/DRUG THERAPY/MORTALITY/PATHOLOGY Male Middle Age Prognosis Remission Induction Survival Rate Treatment Outcome Vidarabine/ANALOGS & DERIVATIVES/ADMINISTRATION & DOSAGE

Most Read: Latest Added Related Topics White House LGBT Conference on HIV/AIDS UNITED STATES: White House in Atlanta: LGBT AIDS Conference No more single-theme conferences: global HIV prevention conference planned FHI 360 Senior Scientist Lut Van Damme Receives International Microbicide Conference Lifetime Achievement Award Photographs from A Day with HIV Now Online Equatorial Guinea Ministry of Health and Social Welfare and UNICEF Refute Erroneous AIDS Prevalence Figures Bulgaria urges Libya to investigate AIDS nurses case Engineers enter fight against AIDS in Africa Gilead’s Complera® Non-Inferior to Atripla® Among Treatment-Naive HIV Patients UN chief Ban calls world leaders to end Aids by 2020 ARIZONA: Routine Skin Testing Available Again at Tuberculosis Clinic Starting May 20 NORTH DAKOTA: Officials: 26 Tuberculosis Cases from Grand Forks Outbreak AUSTRALIA: HIV Rates Triple in the Northern Territory in Just 12 Months ARIZONA: Parsons Foundation Gives $3 Million to Southwest Center for HIV/AIDS UNITED STATES: Triple Therapy for Hepatitis C is Effective After Liver Transplantation, but Side-Effects Are Common CANADA: Nunavut Uses Comic Book to Do Sex Education NEW HAMPSHIRE: State Health Officials Urge Hepatitis Testing UNITED STATES: Hepatitis C Testing for People Born Between 1945 and 1965 People with HIV pay more for life insurance – if they can get it (South Africa)Uganda: Gov't Urged to Levy a Tax On Alcohol to Fund HIV UNITED STATES: Triple Therapy for Hepatitis C is Effective After Liver Transplantation, but Side-Effects Are Common Experimental Gilead drug effective in early-stage leukemia trial KENTUCKY: Northern Kentucky Health Department Ready to Give Low-Cost Hepatitis B Vaccines to Adults KOREA: U.S. Non-Profit Group to Build Tuberculosis Center in Pyongyang AFRICA: Less-Used HIV Treatment for African Children More Effective Less-Used HIV Treatment for African Children More Effective EGYPT: Egypt Has One of the Lowest HIV Rates: Health and Population Ministry New Findings from A.M. Cavalcanti and Colleagues Has Provided New Data on Genetics and HIV/AIDS OHIO: Research Finds Targeted Screening for Hepatitis C is Cost-Effective OHIO: Research Finds Targeted Screening for Hepatitis C is Cost-Effective
Information in this article was accurate in July 30, 1999. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.