The feasibility of using topotecan, vinorelbine, thiotepa and gemcitabine (TVTG) in adult patients with relapsed/refractory acute lymphoblastic leukaemia/lymphoma.

The success of haematopoietic stem cell transplantation depends upon the pretransplant leukaemic burden.1 In relapsed or refractory acute leukaemia and high-grade non-Hodgkin's lymphoma, the main aim is to decrease the leukaemic cell population to submicroscopic level so that consolidation with haematopoietic stem cell transplantation can be performed. In these heavily pretreated patients, there are issues of development of drug resistance and further risk of comorbidities from salvage chemotherapy. Thus for prolonged survival of such patients, a protocol that can induce disease remission to last long enough to perform haematopoietic stem cell transplantation and also prevent vital organ dysfunction is required.