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Background: Autologous haemopoietic stem cell transplantation (AHSCT) is being currently explored as a possible alternative treatment in patients with severe multiple sclerosis (MS). Information on the effect of AHSCT on [...]

Patients and methods: We designed a study mainly directed towards investigating MRI and laboratory changes after autologous PBPC transplantation in patients affected by advanced, poor prognosis and refractory MS. The [...]

The management of indolent lymphomas is still controversial. Intensive therapies may improve remission rate but in association with toxicity. Fludarabine and idarubicin are very active drugs in indolent lymphomas. This pilot trial was designed to evaluate the efficacy of a regimen comprising fludarabine, idarubicin and prednisone (FLIDA) in the treatment of low‐grade non‐Hodgkin's lymphoma at diagnosis. We have assessed the response of 16 adult patients (median age 57 years, range 45–71 years) treated on an outpatient basis: the overall response rate was 93.8 per cent (CR 43.8 per cent, PR ≥50 per cent). The toxicity of this regimen was very low, with no relevant hematological and infectious complications. © 1997 John Wiley & Sons, Ltd.

Between July 1990 and March 1992, 23 elderly patients with intermediate or high-grade non-Hodgkin's lymphomas (NHL) received a combination chemotherapy (P-VABEC: Etoposide, Adriamicin and Cyclophosphamide on days1, 15, 29, 43, Vincristine and Bleomycin on days8, 22, 36, 50 and Prednisolone on weeks 1-9). The regimen was administered on an outpatient basis. The median age of the patients was 67 years (range 60-78); 15 were previously untreated, 8 were on second line therapy; 6 patients (44%) had stage IV disease, 19 (83%) B symptoms, 15 (65%) had bulky disease, and (26 %) bone marrow involvement. The complete remission (CR) rate was 57%, and the partial remission (PR) rate 43%, with an overall response rate of (100%). No difference in response rate was observed between previously untreated patients and patients treated with P-VABEC as second-line therapy while hema-tological and clinical toxicity were very mild.

Aggressive treatments in elderly patients with NHL are often responsible for acute complications and increased mortality. The present study confirms that P-VABEC is able to induce a high CR rate (71%), with an overall response rate of 92%. The 4-year actuarial 0s was 45%. and the FFS was 38%. Despite these good results 57% of CRs relapsed in a relatively short time (median 9.5 months; range 2-47). Because of this we decided to evaluate the role of a consolidation schedule (CIP), including idarubicin and cisplatin. The toxicity of P-VABECKIP regimen was comparable to that of P-VABEC alone. After a median follow-up of 20 months (range 8-49), 93% of CR patients treated with P-VABEC-CIP were still in complete remission. The 4-year actuarial overall survival was 92%. and the failure-free survival in CR patients was 72%. The difference in OS and FFS between the two groups was statistically significant. These results suggest that a short course of additional therapy is feasible in elderly patients treated with P-VABEC and may increase the OS and FFS, without adding toxicity.

Previous studies (Martelli et al. J. Clin. Oncol. 1993. Caracciolo et al. Leukemia & Lymphoma 1993, Hematol. Oncol. 1994) have shown the efficacy and tolerability of a weekly multidrug protocol (P-VABEC) in elderly patients with NHL. This study preliminarly evaluates the results of a consolidation therapy with Cisplatin, Idarubicinand Prednisolonein unselected patients.