A Prospective Randomized Study of Chop Versus Chop Plus Alpha-2B Interferon in Patients with Intermediate and High Grade Non-Hodgkin's Lymphoma: The International Oncology Study Group NHL1 Study

Fj, Giles; Shan, Jianqin; Sh, Advani; Akan, Hamdı; Aydogdu, Ismet; Aziz, Zeba; Azim, Hatem Hamdy Abdel; Bapsy, P P; Büyükkeçeci, Filiz; Chaimongkol, Boonsom; Pm, Chen; Sk, Cheong; Ferhanoğlu, Burhan; Hamza, R; Hm, Khalid; Intragumtornchai, Tanin; Sw, Kim; Sy, Kim; Koç, Hüsnü; Kumar, Lalit; Kumar, Rajat; Ki, Lei; Lekhakula, Arnuparp; Muthalib, Abdul; Patel, Moosa; Vp, Poovalingam; Prayoonwiwat, Wichai; Rana, F.; Ah, Reksodiputro; Ruff, Paul; Tg, Sagar; Ap, Schwarer; Hs, Song; Cw, Suh; Suharti, Catharina; Supindiman, I; Gy, Tee; Thamprasit, T; Ah, Villalon; Nr, Wickham; Je, Wong; Yalçın, Atilla; Jootar, Saengsuree

doi:10.3109/10428190009054885

Cited by 10 publications

(5 citation statements)

References 23 publications

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“…Especially, R-CHOP regimen has been established as the gold standard treatment regimen by Groupe d'Etude des Lymphomes de l'Adulte (GELA) NHL trial (GELA LNH-98-5). 18 Decreased hepatic and renal function and changed distribution ratio of water and fat in the body with ageing require a dose adjustment and if given at a normal dose, the incidence of side effects increases. Among these effects, mucositis, myelosuppression and cardiotoxicity are commonly encountered.…”

Section: Discussionmentioning

confidence: 99%

Treatment modalities of non-Hodgkin lymphoma patients over 65 years of age: A two-center experience

Çetin

Doğan²,

Samancı

et al. 2019

J Oncol Pharm Pract

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Objective This study was conducted with the aim of making the contribution to a decision for treatment and determination of the modalities in patients diagnosed with non-Hodgkın lymphoma which increasingly become widespread in the geriatric population. Materials and methods Ninety-one patients aged over 65 years diagnosed with lymphoma and treated in Bezmialem Vakıf University Medical Faculty Hospital and Haseki Training and Research Hospital between 2008 and 2013 were retrospectively evaluated. Finally, 63 patients for whom data could be reached were included in the study. Results Examining the results, histological diagnoses of our patients were as follows: diffuse large B-cell lymphoma (50.8%), follicular lymphoma (23.8%), marginal zone lymphoma (12.7%), mantle cell lymphoma (4.8%), T-cell lymphoma (4.8%), lymphoplasmacytic lymphoma (1.6%) and small lymphocytic lymphoma (1.6%). Stages at the time of diagnosis were early stage by 33.3% and late stage by 66.7%. Of the patients, 36.5% had a low-intermediate and 63.5% a high-intermediate International Prognostic Index score. According to the Eastern Cooperative Oncology Group scoring, 34.9% of the patients have an Eastern Cooperative Oncology Group score of 2–4. Activities of daily living score of 33.3% patients was under 5. Looking at the responses to treatment, the complete response was found in 50.8%, partial response in 4.8%, stable disease in 1.6% and progressive disease in 9.5% of the patients. The mean follow-up duration of patients was found as 25.2 months and disease-free survival after remission as 20.2 months. Conclusion We found that we have achieved a complete remission in more than half of our patients (50.8%). Based on this, treatment should aim remission in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Treatment modalities of non-Hodgkin lymphoma patients over 65 years of age: A two-center experience

Çetin

Doğan²,

Samancı

et al. 2019

J Oncol Pharm Pract

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“…The estimated 5-year OS and EFS for patients who received IFN were 71% (95% CI: 61 ± 83%) and 57% (95% CI: 39 ± 69%), respectively, values which were not statistically different from the control group: 69% (95% CI: 63 ± 79%) and 54% (95% CI: 37 ± 63%), respectively (P= 0. Among the 214 patients randomized to receive CHOP alone, The Overall RR was 81% compared to 80% in the group receiving CHOP and IFN; after a median follow up of 36 months, there was no apparent difference in survival between the 2 treatment arms 16 .…”

Section: Interferon In Diffuse Large B Cell Lymphomamentioning

confidence: 93%

One Year of Maintenance Metronomic Cyclophosphamide, Methotreaxate & Celecoxib in High Risk Diffuse Large B Cell Non Hodgkin Lymphoma After Complete Response.

Alhassanin

Hashem

Eldin

et al. 2014

Kasr-Al-Aini J.of Clin. Onc. and Nuc. Med.

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IntroductIonCombination chemotherapy with Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) has been the mainstay of treatment for several decades with complete response rates (RR) of 45-55% and cure rates of approximately 30-35% in aggressive NHL; the addition of the immunotherapeutic agent Rituximab to chemotherapy (R-CHOP) has improved complete RR to 76-86% and OS rates significantly. Nevertheless, variability in response rates, and particularly in event free survival (EFS) and OS, have been observed in these trials, and up to one-third of all patients experience progression or relapse of their disease. Outcomes in relapsed or refractory DLBCL are poor, with a median survival approximating 6 months. Salvage chemotherapy followed by high-dose therapy and autologous stemcell transplantation (HDT-ASCT) is widely considered the standard treatment for relapsed DLBCL, though the ORR and EFS are significantly lower in this setting as compared to those observed in upfront treatment. Many patients, moreover, are not eligible for transplant, and of those that are, about half fail to respond to salvage therapy, becoming ineligible for HDT-ASCT 1 .Recent data indicate that angiogenesis is important in the pathophysiology and prognosis of aggressive histologic subtypes of NHL 2 . Angiogenesis and angiogenic factors are increased in most lymphomas. In addition, angiogenesis has been associated with adverse outcomes or more aggressive clinical behavior in malignant lymphoma. However, the role of angiogenesis might vary in lymphoma subtypes because of the prognostic value of microvessel density and the different Surgical department-Faculty of medicine-Menofia University-Egypt.Background & purpose: Diffuse large B cell lymphoma (DLBCL) is the most common subtype of NonHodgkin lymphoma (NHL). Although cure rates are increased after the addition of Rituximab to the standard CHOP; yet there is a significant number -especially of high risk-patients get relapse and have a poor response to second-line regimens. Novel approaches are needed for DLBCL treatment. We conducted this trial to evaluate the role of metronomic maintenance chemotherapy in patients with high risk DLBCL who enter in complete response (CR) after first line standard chemotherapy. Patients and methods: this is a prospective phase II single arm study done on 40 patients with high risk DLBCL. All patients received metronomic maintenance chemotherapy for one year (who had CR after standard R-CHOP) in the form of oral Cyclophosphamide (50 mg every day), oral Methotrexate (2.5 mg 4 times/week) and high-dose oral Celecoxib (400 mg twice daily). results: thirty five and 65 percent of patients presented with stage III and IV respectively, 29 patients (72.5%) had international prognostic index (IPI) score of 3 (high intermediate), while11 patients (27.5%) had IPI score of 4 or 5 (high). The most common toxicity was grade I and II hematological and gastrointestinal toxicity. Grade I fatigue was the most remarkable side effect noticed in 27.5% of patients. N...

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“…10,25,33 Unfortunately, the histology classification systems applied differed, although in most publications the Working Formulation 38 was used. [11][12][13][15][16][17]21,24,27,28,30 In four trials 10,19,25,33 the Kiel classification was applied, 39 while in three 29,32,33 (also) the REAL classification was used. 40 In one publication, 26 the classification system was not explicitly mentioned.…”

Section: Number Of Publicationsmentioning

confidence: 99%

“…15,22 In all, 19 publications were finally included in the analysis. [10][11][12][13][15][16][17]19,21,[24][25][26][27][28][29][30][31][32][33] Inclusion and exclusion criteria (moderator variables of the first order) Table 1 presents an overview of the inclusion and exclusion criteria applied within the trials, as mentioned within the publications. Most of the trials included both intermediate and high-grade lymphomas.…”

Section: Number Of Publicationsmentioning

confidence: 99%

“…Most of the trials included both intermediate and high-grade lymphomas. [11][12][13][15][16][17]21,24,[26][27][28][29][30][31][32] One trial 19 only included intermediate-grade lymphomas, while three included high-grade lymphomas only. 10,25,33 Unfortunately, the histology classification systems applied differed, although in most publications the Working Formulation 38 was used.…”

Section: Number Of Publicationsmentioning

confidence: 99%

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A review of recruitment criteria, patient characteristics and results of CHOP chemotherapy in prospective randomized phase III clinical trials for aggressive non-Hodgkin's lymphoma

Agthoven¹,

Sonneveld²,

Hagenbeek³

et al. 2003

Hematol J

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It has frequently been questioned whether results of trials can be generalized to routine clinical practice. Results obtained with standard cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) chemotherapy for aggressive non-Hodgkin's lymphoma in the control arm of prospective randomized phase III clinical trials during the past 25 years appear to be comparable. As the possibility to generalize trial results is favored by such consistency, we tested this hypothesis and tried to indicate explanatory 'moderator variables' (inclusion and exclusion criteria, therapy characteristics, sample sizes, inequalities in the distribution of patients over prognostic categories across different trials) in the case of divergent trial results. Trial results on conventional CHOP chemotherapy were obtained from literature research. Overall response (OR), complete response (CR) and two-year overall survival (2YS) were considered as outcome measures. Although OR rates and 2YS rates were within acceptable limits of comparability, the absolute differences within the results were remarkably wide, particularly with regard to CR and 2YS. Divergent rates could not be properly explained by differences in the moderator variables. We conclude that absolute results obtained with CHOP in the control arm of trials appeared to be poorly generalizable to routine clinical practice, particularly in the case of elderly patients. This analysis underlines the need for the strict application of internationally agreed response criteria and the WHO classification system, large sample sizes and stratifying patients on the basis of prognostic factors, preferably in intergroup clinical trials. We expect those factors to lead to a better consistency of results in future trials and improved possibilities to generalize the results.

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A Prospective Randomized Study of Chop Versus Chop Plus Alpha-2B Interferon in Patients with Intermediate and High Grade Non-Hodgkin's Lymphoma: The International Oncology Study Group NHL1 Study

Abstract: There is no apparent early advantage in terms of response or survival conferred by adding the study INF regimen to CHOP therapy for patients with IG/HG-NHL.

Cited by 10 publications

References 23 publications

Treatment modalities of non-Hodgkin lymphoma patients over 65 years of age: A two-center experience

Treatment modalities of non-Hodgkin lymphoma patients over 65 years of age: A two-center experience

One Year of Maintenance Metronomic Cyclophosphamide, Methotreaxate & Celecoxib in High Risk Diffuse Large B Cell Non Hodgkin Lymphoma After Complete Response.

A review of recruitment criteria, patient characteristics and results of CHOP chemotherapy in prospective randomized phase III clinical trials for aggressive non-Hodgkin's lymphoma

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