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Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL.
- Source :
-
Blood [Blood] 2004 Aug 01; Vol. 104 (3), pp. 626-33. Date of Electronic Publication: 2004 Feb 24. - Publication Year :
- 2004
-
Abstract
- The combination of cyclophosphamide, doxorubicin, vincristine, and prednisone, given every 3 weeks (CHOP-21) is standard chemotherapy for aggressive lymphomas. To determine whether CHOP given every 2 weeks (CHOP-14) or the addition of etoposide (CHOEP-21, CHOEP-14) can improve results in patients ages 18 to 60 years with good prognosis (normal lactic dehydrogenase [LDH] level), 710 patients were randomized to 6 cycles of CHOP-21, CHOP-14, CHOEP-21 (CHOP plus etoposide 100 mg/m2 days 1-3), or CHOEP-14 in a 2 x 2 factorial study design. Patients in the biweekly regimens received granulocyte colony-stimulating factor (G-CSF) starting from day 4. Patients received radiotherapy (36 Gy) to sites of initial bulky disease and extranodal disease. CHOEP achieved better complete remission (87.6% versus 79.4%; P =.003) and 5-year event-free survival rates (69.2% versus 57.6%; P =.004, primary end point) than CHOP, whereas interval reduction improved overall survival (P =.05; P =.044 in the multivariate analysis). Although the CHOEP regimens induced more myelosuppression, all regimens were well tolerated. CHOEP should be the preferred chemotherapy regimen for young patients with good-prognosis (normal LDH level) aggressive lymphoma.
- Subjects :
- Adolescent
Adult
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Cyclophosphamide administration & dosage
Disease Progression
Doxorubicin administration & dosage
Drug Administration Schedule
Factor Analysis, Statistical
Follow-Up Studies
Granulocyte Colony-Stimulating Factor therapeutic use
Humans
L-Lactate Dehydrogenase blood
Lymphoma, B-Cell blood
Lymphoma, B-Cell classification
Lymphoma, B-Cell mortality
Lymphoma, T-Cell blood
Lymphoma, T-Cell classification
Lymphoma, T-Cell mortality
Middle Aged
Prednisone administration & dosage
Prognosis
Recombinant Proteins
Survival Rate
Time Factors
Treatment Outcome
Vincristine administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Etoposide therapeutic use
Lymphoma, B-Cell drug therapy
Lymphoma, T-Cell drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 0006-4971
- Volume :
- 104
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Blood
- Publication Type :
- Academic Journal
- Accession number :
- 14982884
- Full Text :
- https://doi.org/10.1182/blood-2003-06-2094