Fludarabine and mitoxantrone: Effective and well-tolerated salvage therapy in relapsed indolent lymphoproliferative disorders

Abstract

Background: Prior studies of the combination of fludarabine, mitoxantrone and dexamethasone have yielded high response rates but are associated with a significant risk of opportunistic infections, predominantly Pneumocystis Carinii pneumonia (PCP) requiring routine prophylaxis. Patients and methods: We evaluated the combination of fludarabine (25 mg/m2/day × 3) and mitoxantrone (10 mg/m2 × 1) without corticosteroids or PCP prophylaxis in 29 patients with relapsed or refractory indolent lymphoproliferative disorders; median age 56 years, 62% refractory to preceding chemotherapy. Results: A median of four cycles was administered without cumulative myelosuppression. Neutropenia < 0.5 × 109/1 wa..