CEOP treatment results and validity of the International Prognostic Index in Chinese patients with aggressive non-Hodgkin's lymphoma

Abstract

From 1991 to 1997, we have treated 78 newly diagnosed patients with aggressive non-Hodgkin's lymphoma with a modified CHOP regimen in which epirubicin (60 mg/m2) was used in place of doxorubicin (50 mg/m2), i.e. CEOP (cyclophosphamide, epirubicin, vincristine and prednisolone). The median age was 41 years (range: 17 to 67). Sixty-four (82 per cent) had diffuse large cell (Working Formulation category G) histology. The median LDH level was 453 u/l. Thirty-three (42.3 per cent) and 45 (57.7 per cent) had stage I/II and stage III/IV disease, respectively. Fifty-five of 78 (71 per cent) CEOP-treated patients achieved CR, and the projected DFS and OS were both 65 per cent. In an earlier cohort of patients (from 1985-1991) treated with second or third-generation chemotherapy regimens (m-BACOD, MACOP-B, ProMACE-CytaBOM), CR was achieved in 95/123 (77 per cent) patients and the projected DFS and OS were 62 per cent and 55 per cent. There was no significant difference in the clinical characteristics, CR rates (p = 0.26), DFS (p = 0.38) or OS (p = 0.68) between patients who received CEOP or second/third-generation chemotherapy regimens. Of the patients treated with CEOP, 37.9 per cent, 28.8 per cent, 24.2 per cent and 9.1 per cent were in the age-adjusted International Index L, LI, HI and H risk groups, with CR rates of 82 per cent and 57 per cent in the L/LI and HI/H risk groups (p = 0.03). Moreover, patients in the L, LI and HI/H risk groups had significantly different projected DFS (87 per cent, 62 per cent and 39 per cent, p = 0.02) and OS (85 per cent, 80 per cent and 36 per cent, p = 0.006). In conclusion, CEOP is an effective regimen and the age-adjusted International Index is valid for Chinese patients with aggressive NHL.

Epirubicin as part of a multi‐agent chemotherapy protocol for canine lymphoma

“… Given the reduced toxicity and equipotent activity, epirubicin is currently used extensively in the treatment of a range of human malignancies including breast cancer and lymphoma. In contrast, the use of epirubicin has been infrequently described in veterinary medicine. The available veterinary literature includes the outcome of a small number of epirubicin‐treated dogs with haemangiosarcoma.…”

Fludarabine, mitoxantrone and dexamethasone in the treatment of indolent B‐ and T‐cell lymphoid malignancies in Chinese patients

“…Until now, it has not been defined whether the low incidences of indolent B‐cell malignancies in Chinese patients when compared with Western patients might reflect intrinsic biological differences, which might become clinically manifest as differences in treatment outcome. Although the treatment results of high‐grade B‐cell lymphomas in Chinese patients were reported to be comparable with Western patients (Chim et al , 1998; Mok et al , 1998), similar studies on indolent lymphomas have not been reported. This study is the first to show that treatment results of FND in Chinese patients are comparable with Western ones.…”

Long‐term follow‐up of patients with intermediate or high‐grade non‐Hodgkin lymphoma treated with a combination of cyclophosphamide, epirubicin, vincristine, and prednisone

“…Consequently, the use of EPI may be particularly suitable for more aggressive treatments, based on its dose intensity and dose density, without the need for autologous stem cell transplantation or the support of growth factors 7. However, it has not yet been proved that the routine use of these more intensive regimens improves the outcome of patients with NHL, and it is likely that they would be beneficial only in certain limited patient populations 9–13…”