Severe myelotoxicity of oral etoposide in heavily pretreated patients with non-Hodgkin's lymphoma or chronic lymphatic leukemia

Cancer. 1996 Jun 1;77(11):2313-7. doi: 10.1002/(SICI)1097-0142(19960601)77:11<2313::AID-CNCR20>3.0.CO;2-Z.

Abstract

Background: Promising results have been reported for patients with non-Hodgkin's lymphoma (NHL) receiving chronic oral etoposide. Due to the small number of patients reported, information regarding side effects is limited, and therefore warrants further evaluation.

Methods: Twenty eligible patients with NHL and chronic lymphatic leukemia (CLL), resistant to or relapsed after previous protocols of polychemotherapy were treated with oral etoposide at a dosage of 50 mg/m2/day for 21 days in a 28-day cycle. Response and toxicity were evaluated according to standard criteria.

Results: Total response was noted in 13 patients, complete response in 2 patients, and partial response in 11 patients. Two patients had stable disease and five patients had progression of disease during treatment. Seventy-five percent of patients experienced neutropenia below 1500/microL. Half acquired infection and required hospitalization. Fifty-five percent required blood transfusions. All patients needed course shortening and dosage reduction.

Conclusions: Chronic daily administration of oral etoposide is effective in patients with NHL and CLL. In heavily pretreated patients, myelotoxicity is severe. Therefore, modification of the schedule plan is mandatory in this group of patients.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Agents, Phytogenic / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bone Marrow Diseases / chemically induced
  • Disease Progression
  • Disease Susceptibility / chemically induced
  • Etoposide / administration & dosage
  • Etoposide / adverse effects*
  • Female
  • Gastrointestinal Diseases / chemically induced
  • Humans
  • Infections / etiology*
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukocyte Count
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Male
  • Middle Aged
  • Neutropenia / chemically induced*
  • Prednisone / therapeutic use
  • Remission Induction
  • Salvage Therapy

Substances

  • Antineoplastic Agents, Phytogenic
  • Etoposide
  • Prednisone