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Comparison of two high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone derived regimens in patients aged under 60 years with low-intermediate risk aggressive lymphoma: a final analysis of the multicenter LNH93-2 protocol

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Morel, Pierre Munck, Jean-Nicolas Coiffier, Bertrand Gisselbrecht, Christian Ranta, Dana Bosly, André [UCL] Reyes, Felix

One-third of patients aged <= 60 years with aggressive lymphoma are at low-intermediate risk (LIR). Before the rituximab era, we prospectively compared ACVBP with ECVBP, a similar regimen including epirubicin instead of doxorubicin and increased dose intensity of cyclophosphamide, followed by conventional consolidation with an increased amount and dose intensity of cytosine-arabinoside, methotrexate, etoposide, and ifosfamide, in 652 patients with LIR aggressive lymphoma. The overall response rate, 5-year event-free survival (EFS), and survival were estimated to be 86%, 60%, and 74%, respectively, with no differences between the two arms. In patients with diffuse large B-cell lymphoma (DLBCL) who received ACVBP, the 5-year EFS and survival were estimated at 69% and 82%. These findings do not support the use of a chemotherapy regimen more intensive than ACVBP in patients aged <= 60 years with LIR aggressive lymphoma. The results in the control arm, without rituximab, have led to a randomized comparison of R-ACVBP and R-CHOP in this patient population.

Document type Article de périodique (Journal article) – Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
Access type Accès restreint
Publication date 2010
Language Anglais
Journal information "Leukemia and Lymphoma" - Vol. 51, no. 9, p. 1668-77 (2010)
Peer reviewed yes
Publisher Taylor & Francis Ltd (Abingdon)
issn 1042-8194
e-issn 1029-2403
Publication status Publié
Affiliations UCL - SSS/IREC - Institut de recherche expérimentale et clinique
UCL - SSS/IREC/MONT - Pôle Mont Godinne
UCL - (MGD) Service d'hématologie
MESH Subject Young Adult ; Vindesine - administration & dosage ; Survival Rate ; Prospective Studies ; Prognosis ; Prednisone - administration & dosage ; Neoplasm Staging ; Middle Aged ; Methotrexate - administration & dosage ; Male ; Lymphoma, Large B-Cell, Diffuse - drug therapy - metabolism - pathology ; Ifosfamide - administration & dosage ; Humans ; Follow-Up Studies ; Female ; Etoposide - administration & dosage ; Doxorubicin - administration & dosage ; Cytarabine - administration & dosage ; Cyclophosphamide - administration & dosage ; Bleomycin - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Adult ; Adolescent
Keywords Aggressive non-Hodgkin lymphoma ; chemotherapy model ; clinical trial ; dose escalation
Links
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Bibliographic reference Morel, Pierre ; Munck, Jean-Nicolas ; Coiffier, Bertrand ; Gisselbrecht, Christian ; Ranta, Dana ; et. al. Comparison of two high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone derived regimens in patients aged under 60 years with low-intermediate risk aggressive lymphoma: a final analysis of the multicenter LNH93-2 protocol. In: Leukemia and Lymphoma, Vol. 51, no. 9, p. 1668-77 (2010)
Permanent URL http://hdl.handle.net/2078.1/33774