Chemotherapy for diffuse large-cell lymphoma--rapidly responding patients have more durable remissions.

Abstract

Fifty-one patients with diffuse large-cell lymphoma (DLCL) were treated with a six-drug combination chemotherapy regimen including cyclophosphamide, doxorubicin, procarbazine, bleomycin, vincristine, and prednisone. The patients were restaged after three cycles of therapy, and restaging was repeated at 2-month intervals in patients who had persistent disease. Responding patients received two cycles of therapy after documentation of complete remission (CR). With all patients considered evaluable, 73% of the patients achieved a CR. Twenty-six of the 37 CRs (70%) achieved remission in the first three treatment cycles. The durability of remission in the rapidly responding patients was significantly better than for patients who required five cycles to achieve CR (80% v 40% at 2 years, P = .02) despite the latter patients having received two more cycles of therapy. Rapidly responding patients with DLCL do not require prolonged therapy and have a better prognosis than patients achieving a CR more slowly.

A phase II trial of adjuvant low-dose total body irradiation in non-hodgkin's lymphoma patients following standard CHOP

“…Early responders to chemotherapy are known to have more durable remissions (21). The better DFS of patients who achieved early complete remission is therefore not surprising.…”

Full dose chemotherapy in elderly patients with non-Hodgkin's lymphoma: a feasibility study using a mitoxantrone containing regimen

“…Complete response rates of stage II-IV unfavourable NHL ranging from 40 to 80% can be achieved using anthracycline-containing regimens like ProMaceMOPP (Fisher et al, 1983), M-BACOD (Skarin et al, 1983), COP-BLAM (Laurence et al, 1982), MACOP-B (Klimo & Connors, 1987) and CHOP (Armitage et al, 1986). In these studies a high complete response rate is associated with improved survival.…”

Economic evaluation of cancer treatments

“…Initially, in these phase II single institution studies remission and survival rates improved, but prospective comparative trials did not demonstrate superiority of the new treatment programmes; the efficacy of first, second and third generation treatment regimens demonstrated similar results (Fisher et al, 1993;Gordon et al, 1992;Armitage et al, 1986). Hence, the combination of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) has remained the standard treatment for patients with intelmediateand high-grade NHL until today.…”