A cooperative study on ProMACE-CytaBOM in aggressive non-Hodgkin's lymphomas.

Abstract

Chemotherapy using cyclophosphamide, doxorubicin, etoposide, cytarabine, bleomycin, vincristine, methotrexate with leucovorin, and prednisone (ProMACE-CytaBOM) for patients with intermediate or high grade non-Hodgkin lymphomas (G, H and K according to the Working Formulation), was tested by the Gruppo Cooperativo Lombardo to confirm the activity of the regimen and to test the feasibility and safety of administering third-generation drug regimen in a cooperative group setting. Among 64 previously untreated patients, aged between 20 and 71 years, 7 had stage IB-IIB, 12 had stage IIIA-B, 45 (67%) had stage IVA-B. There were 44 complete remissions (CRs) (69%) and 14 partial remissions (22%); the difference between patients in stage I-II-III (84% complete remissions) and those in stage IV (62% complete remissions) was statistically significant. The median length of follow up was 20 months (range 1-60 months), with 56% of patients alive at 60 months and 53% of CRs patients free of disease at 60 months. Patients in stage I-II-III have the best survival and disease free survival compared to stage IV, 87% versus 42% and 72% versus 32% respectively (both with high statistical significance). Grade 3-4 (WHO) haematological toxicity was observed in 39% of patients, with 3 septic deaths. Two more patients died with chemotherapy related toxicity (1 stroke and 1 acute renal insufficiency). Administration of ProMACE-CytaBOM is a feasible and safe regimen although it presents moderate toxicity. ProMACE-CytaBOM may represent improved treatment for aggressive lymphomas, in terms of duration of response and survival, but a longer follow up is needed.

• Authors: E Cassi, C Butti, L Baldini, G B Pisoni, A Ceriani, C Confalonieri, L Scandolaro, A De Paoli, F Lombardi, L Montalbetti
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 13 Issue 1-2 Pg. 111-8 (Mar 1994) ISSN: 1042-8194 [Print] United States
• PMID: 7517742 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Cytarabine
• Bleomycin
• Vincristine
• Etoposide
• Doxorubicin
• Cyclophosphamide
• Leucovorin
• Prednisone
• Methotrexate

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use, toxicity)
• Bleomycin (administration & dosage, toxicity)
• Child
• Cyclophosphamide (administration & dosage, toxicity)
• Cytarabine (administration & dosage)
• Doxorubicin (administration & dosage, toxicity)
• Etoposide (administration & dosage, toxicity)
• Feasibility Studies
• Humans
• Leucovorin (administration & dosage, toxicity)
• Lymphoma, Non-Hodgkin (drug therapy, mortality, pathology)
• Methotrexate (administration & dosage, toxicity)
• Middle Aged
• Neoplasm Staging
• Prednisone (administration & dosage, toxicity)
• Vincristine (administration & dosage, toxicity)