Activity of the Epipodophyllotoxin VP‐16 in the Treatment of Combination Chemotherapy‐Resistant Non‐Hodgkin Lymphoma

• Published in: American Journal of Hematology
• Main Authors: Bender, Richard A., Anderson, Tom, Fisher, Richard I., Young, Robert C.
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wiley 1978
• Subjects: General Medicine; DML
• Online Access: http://dx.doi.org/10.1002/ajh.2830050305; https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1002%2Fajh.2830050305; https://onlinelibrary.wiley.com/doi/pdf/10.1002/ajh.2830050305

Abstract Twenty patients with several histologic subtypes of non‐Hodgkin lymphoma who had become resistant to combination chemotherapy were treated with a five‐day course of the epipodophyllotoxin VP‐16. Of 19 evaluable patients, 8 (42%) responded to treatment with 1 complete response and 7 partial responses. The median duration of response was 5.5 months. Seven of the responders had a diffuse lymphoma and 1 had a nodular lymphoma. Of the responders who had diffuse histiocytic lymphoma (DHL), diffuse mixed lymphoma (DML), and diffuse undifferentiated lymphoma (DUL)–the more aggressive histologies in the Rappaport classification–6 of 13 (46%) evaluable patients responded to therapy. Responses were seen in node‐dominant, skin‐dominant, and marrow‐dominant disease. Toxicity was mainly hematopoietic, 53% of patients experiencing leukopenia (<2, 000 cells per cu mm) and 68% of patients experiencing thrombocytopenia (<100, 000 platelets per cu mm). There were two deaths attributable to profound leukopenia with sepsis. The activity of VP‐16 in patients who have previously been extensively treated with multiple drugs including vincristine supports its activity in the lymphomas and suggests its lack of cross‐resistance with vincristine. The inclusion of VP‐16 in primary treatment protocols in the diffuse lymphomas should be considered.