Efficacy and Safety Study of Oral Fludarabine Phosphate in Combination With Mitoxantrone as First Line Treatment in Follicular NHL

Inclusion Criteria: Indolent B-cell follicular non-Hodgkin's lymphoma (grade I-II according to REAL classification) Stage II to IV according to Ann Arbor staging system WHO performance status grade 0, 1 or 2 and life expectancy of greater than 6 months Exclusion Criteria: Patients who have received any previous treatment for follicular NHL Patients with severe or life-threatening cardiac, pulmonary, neurological, psychiatric or metabolic disease Pregnant and lactating women Women of childbearing potential, and all men, not agreeing to take adequate contraceptive precautions during and for at least 6 months after cessation of therapy Laboratory screens positive for Hepatitis B, C or HIV infections Patients with autoimmune thrombocytopenia or hemolytic anemia with clinical evidence. NB. A positive Coombs test alone (with no clinical evidence of hemolysis) would not preclude entry in the study. Histological transformation to aggressive B-cell lymphoma Patients with prior malignancies except non melanoma skin tumors or stage 0 (in situ) cervical carcinoma Impairment of hepatic function unless disease related indicated by bilirubin, ASAT, ALAT or gamma-GT raised 2 times above the upper limit of the local laboratory range Impairment of renal function indicated by serum creatinine < 30 ml/min Patients who require systemic long-term therapy with glucocorticoids Participation at the same time in another study in which investigational drugs are used Patients unable to regularly attend outpatient clinic for treatment and assessments Any other co-existing medical or psychological condition that would preclude participation in the study or compromise ability to give informed consent Patients with active infection