High molecular response rate and clinical correlation in patients with follicular lymphoma treated with cyclophosphamide-vincristine-prednisone plus interferon alpha 2b.

Abstract

PURPOSE:

The role of molecular monitoring of minimal residual disease (MRD) in low-grade non-Hodgkin's lymphoma is controversial. We have performed a prospective study of the molecular behavior of 35 patients with follicular non-Hodgkin's lymphoma who received cyclophosphamide-vincristine-prednisone chemotherapy in conjunction with IFN-alpha 2b.

EXPERIMENTAL DESIGN:

Bcl-2 and clonal immunoglobulin heavy chain (IgH) gene rearrangements were assayed at diagnosis by PCR in lymph node and bone marrow (BM) and sequentially after treatment.

RESULTS:

Molecular markers were detected in BM of 29 (83%) patients at diagnosis: Bcl-2 rearrangement in 20 patients (90% major breakpoint and 10% minor cluster) and clonal IgH rearrangement in 9 of 15 patients negative for Bcl-2. Molecular and clinical response was noted in 25 (86%) patients after induction treatment. Progression-free survival at 5 years was 78.1 +/- 8%. A correlation between clinical and molecular response was found in 24 patients with molecular markers in BM at diagnosis and >2 years of follow-up: 94% of patients with undetectable MRD showed continuous clinical remission, whereas 50% of patients who reverted back to positive molecular markers relapsed (P < 0.05).

CONCLUSIONS:

The rate of molecular response is high in patients treated with cyclophosphamide-vincristine-prednisone and IFN and MRD sequential analysis is useful for disease surveillance.

• Authors: Elena Fernández-Ruiz, María Cabrerizo, Mara Ortega, Carlos Blas, Pilar Llamas, Matilde Santos-Roncero, Santiago Nieto, Agustín Acevedo, Guillermo Pérez, Concepción Nicolás, José María Fernández-Rañada, Reyes Arranz
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 9 Issue 7 Pg. 2497-503 (Jul 2003) ISSN: 1078-0432 [Print] United States
• PMID: 12855623 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Genetic Markers
• Immunoglobulin Heavy Chains
• Interferon alpha-2
• Interferon-alpha
• Proto-Oncogene Proteins c-bcl-2
• Recombinant Proteins
• Vincristine
• Cyclophosphamide
• Prednisone

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bone Marrow (metabolism)
• Cyclophosphamide (administration & dosage)
• Disease-Free Survival
• Female
• Follow-Up Studies
• Genetic Markers
• Humans
• Immunoglobulin Heavy Chains (immunology)
• Interferon alpha-2
• Interferon-alpha (therapeutic use)
• Lymphatic Metastasis
• Lymphoma, Follicular (drug therapy)
• Male
• Middle Aged
• Polymerase Chain Reaction
• Prednisone (administration & dosage)
• Prospective Studies
• Proto-Oncogene Proteins c-bcl-2 (metabolism)
• Recombinant Proteins
• Time Factors
• Treatment Outcome
• Vincristine (administration & dosage)