Combination Chemotherapy with Pirarubicin (THP), Cyclophosphamide, Vincristine, and Prednisolone (VEP-THP Therapy) in the Treatment of Non-Hodgkin’s Lymphoma

Abstract

Twenty-eight patients with non-Hodgkin’s lymphoma (NHL) were treated with a combination of (2XXX-R)-4′-o-tetrahydropyranyladriamycin (pirarubicin, THP), cyclophosphamide, vincristine, and prednisolone (VEP-THP therapy). Eleven (45.8%) of twenty-four evaluable patients achieved complete response (CR). CR rate (52.8%) was higher in the intermediate-grade histology group than in high- or low-grade group. Toxicity was generally acceptable although leukopenia less than 2,000/ul was observed in 17 (60.7%) of 28 patients. Clinical signs of cardiotoxicity were not observed and alopecia was mild. Therefore, VEP-THP therapy is useful as a first-line chemotherapy in the treatment of NHL, particularly for the patients with intermediate-grade histology. Higher CR rate and longer relapse-free survival can be expected by administering a greater dose of THP or employing a schedule of fractionated low doses.

Improved treatment results of children with B‐cell non‐Hodgkin lymphoma: A report from the Japanese Pediatric Leukemia/Lymphoma Study Group B‐NHL03 study

“…To reduce the risk of cardiotoxicity, we employed THP-adriamycin (pirarubicin) instead of ADR. Pirarubicin is a derivative of ADR with reportedly less cardiotoxicity in adults [19][20][21][22][23][24]. Recently, we have reported that no significant cardiac dysfunction was detected in long-term survivors of children with acute lymphoblastic leukemia who received THP treatment [25][26][27].…”

Long-term results of pirarubicin versus doxorubicin in combination chemotherapy for aggressive non-Hodgkin’s lymphoma: single center, 15-year experience

“…A few published studies, most of which focused on elderly patients, have evaluated the THP-COP regimen in NHL patients. The CR rate in these reports ranged from 30.2 to 72.1%, and the OS rate (5-year results in most studies) ranged from 30.3 to 59.2% [18][19][20][21]. Only one study reported an 8-year OS of 17.4% for elderly patients with aggressive lymphoma [9].…”

Biweekly CHOP or THP-COP regimens in the treatment of newly diagnosed aggressive non-Hodgkin?s lymphoma

“…Aoki et al showed that chemotherapy regimens containing THP are useful and safe for elderly patients with NHL and that THP Non-hematological toxicity Nausea/vomiting 2 (5.0) 1 (2.5) Stomatitis 2 (5.0) 2 (5.0) Diarrhea 0 0 Constipation 1 (2.5) 1 (2.5) Liver dysfunction 1 (2.5) 2 (5.0) Renal dysfunction 1 (2.5) 0 Hematuria 1 (2.5) 0 Arrythmia 1 (5.5) 0 Heart failure 1 0 Respiratory failure 0 1 (2.5) Neuropathy 1 (2.5) 2 (5.0) Infection 1 (2.5) 2 (5.0) showed better results than DOX (Aoki et al 1998). Few reports on the efficacy of THP for treating NHL in young patients are available (Niitsu and Umeda 1998;Takagi et al 1990). In the present study, efficacy and safety were prospectively compared between biweekly THP-COP and CHOP regimens in the treatment of aggressive NHL in patients less than 70 years of age.…”