Key words: low- dose etoposide, non- Hodgkin lymphoma

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Key words: low- dose etoposide, non- Hodgkin lymphoma

Table 1. Patient characteristics and treatments CHF: congestive heart failure, DM: diabetes mellitus, OPCA: olivopontocerebellar atrophy, CRF: chronic renal failire (-) : post- gastrectomy status because of gastric cancer Table 2. Results

Table 3. Related or possibly related toxicities Fig. 1. Clinical course of patient no.10.

Fig. 2. Clinical course of patient no.14. Table 4. Previous studies evaluating oral etoposide for malignant lymphoma HD: Hodgkin disease, ATL: Adult T cell leukemia

2) Johnson D H, Greco F A., Strupp J, et al.: Prolonged administration of oral etoposide in patients with relapsed or refractory small- cell lung cancer: a phase II trial. J. Clin. Oncol. 8: 1613 ` 1617, 1990 3) Clark P I, Cottier B: The activity of 10-, 14-, and 21-day schedules of single- agent etoposide in previously untreated patients with extensive small cell lung cancer. Semin. Oncol. 19 (6 Suppl. 14): 36 `39, 1992 4) Sessa C, Zucchetti M, Torn i V, et al.: Chronic oral etoposide in small- cell lung cancer: Clinical and pharmacokinetic results. Ann. Oncol. 4: 553 `558, 1993 5) Miller J C, Einhorn L H: Phase II study of daily oral etoposide in refractory germ cell tumors. Semin. Oncol. 17 (Supp1. 2): 36 `39, 1990 7) Ratain M J, Kaminer L S, Bitran J D, et al.: Acute nonlymphocytic leukemia following etoposide and cysplatin combination chemotherapy for advanced non- small- cell carcinoma of the lung. Blood 70: 1412 `1417, 1987 8) Boshoff C, Begent R H, Oliver R T, et al.: Secondary tumors following etoposide containing therapy for germ cell cancer. Ann. Oncol. 6: 35 ` 40, 1995 9) Pedersen- Bjergard J, Daugaard G, Hansen S W, et al.: Increased risk of myelodysplasia and leukaemia after etoposide,cysplatin, and bleomycin for germ- cell tumors. Lancet 338: 359 `363, 1991 10) Hainworth J D, Johnson D H, Frazier S R, et al.: Chronic daily administration of oral etoposide in refractory lymphoma. Eur. J. Cancer 26: 818 `821, 1990 14) Haim N, Ben- Shahar M, Epelbaum R: Prolonged daily administration of oral etoposide in lymphoma following prior therapy with Adriamycin, anifosamide- containing salvage combination, and intravenous etoposide. Cancer Chemother. Pharmacol. 36: 352 `355, 1995 16) Devita V T, Jr, Hubbard S M, Longo D L: The chemotherapy of lymphomas. Cancer Res. 47: 5810 18) Chen G L, Yang L, Rowe T C, et al.: Nonintercalative antitumor drugs interfere with the breakage- reunion reaction of mammalian DNA

topoisomerase II. J. Biol. Chem. 259: 13560 ` 13566, 1984 19) Endicott J A, Ling V: The biochemistry of p- glycoprotein mediated multidrug resistance. Ann. Rev. Biochem. 58: 137 `171, 1989 20) Kaufmann S H, Karp J E, Jones R J, et al.: Topoisomerase II levels and drug sensitivity in adult acute myelogenous leukemia. Blood 83: 517 21) Doyle L: Topoisomerase II expression in cancer cell lines and clinical samples. Cancer Chemother. Pharmacol. 34 (Suppl.): 32 `40, 1994 Daily administration of oral etoposide for 2 to 5 weeks for relapsed or elderly lymphoma Katsuro Itoh, Tohru Sakata, Tsuneyuki Shimada, Wakako Gotoh, Takashi Takahashi, Kuniya Kishimoto, Yoshiyuki Kobayashi, Kazuhiro Endoh, Nobutaka Kawai, Kazunori Tominaga, Akira Matsuda, Shuya Kusumoto, Hirohide Ino, Masataka Fukuda, Ikuo Murohashi, Masami Bessho and Kunitake Hirashima1) First Dept. of Int. Medicine,1)Health Management Center, Saitama Medical School, 38 Hongo, Moroyama- cho, Iruma- gun, Saitama 350-0451 Japan We studied the efficacy of daily oral administration of etoposide in 14 patients with non- Hodgkin lymphoma who had visited our hospital from July 1992 to September 1997. Twelve patients had received previous chemotherapy and were considered to be incurable. The other two patients were too old to be treated with intensive chemotherapy. Etoposide was administered at 25 or 50 mg per body per day for 2 `5 weeks. The total response rate was 57.1%(8/ 14), including 1 CR. When diffuse large cell lymphoma (DLCL) was excluded, the response rate was 88.8%(8/ 9). In DLCL cases, neither complete nor partial responses were obtained. Interestingly, two patients with T cell lymphoma responded to the therapy and the skin lesions disappeared. The median response duration was 39.2 weeks. Adverse effects were observed in 4 patients- mild diarrhea in 3 and stomatitis in 1. Bone marrow toxicity was tolerable, and no blood transfusion was required. Taking into consideration the complications and the quality of life of the patients, we believe daily administration of oral etoposide is a safe and useful therapy for elderly or relapsed patients with non- Hodgkin lymphoma, although it is not useful for DLCL.

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