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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.

Authors :
Pfreundschuh M
Trümper L
Kloess M
Schmits R
Feller AC
Rudolph C
Reiser M
Hossfeld DK
Metzner B
Hasenclever D
Schmitz N
Glass B
Rübe C
Loeffler M
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.

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