Comparison of combined and single-agent chemotherapy in non-Hodgkin's lymphoma of favourable histological type.

Abstract

Summary and conclusionsSixty-six untreated patients with advanced non-Hodgkin's lymphoma of favourable histological type were allocated alternately to initial treatment with cyclophosphamide, vincristine, and prednisolone or with chlorambucil. The complete remission rate was higher in the group receiving combination chemotherapy, but the overall response rate was the same for both groups. The mean duration of complete remission was the same as that of good partial remission, and was the same for both treatments. The duration of remission was influenced by histological type and extent of disease at presentation, but not age. Those who responded to the initial treatment (whether with complete or with good partial remission) survived significantly longer than did non-responders.It is concluded that neither treatment is satisfactory and that new treatment programmes are needed for patients with a favourable prognosis, especially young patients with extensive disease.

Combined cyclophosphamide, vincristine, doxorubicin, and prednisone (CHOP) improves response rates but not survival and has lower hematologic toxicity compared with combined mitoxantrone, chlorambucil, and prednisone (MCP) in follicular and mantle cell lymphomas

“…1,3,[19][20][21][22] They demonstrate that remissions can be achieved in a large proportion of patients but that an improvement in remission rate does not translate into a prolongation of TTF, RD, or even OS. 23,24 In contrast, recent data clearly demonstrate that the addition of rituximab to chemotherapy (R-chemo) has a significant impact on response rates and long-term outcomes.…”

How I treat indolent lymphoma

“…27,28 Comparable response rates, but higher CR rates with longer progression-free survival (PFS) are seen with CVP compared with chlorambucil but no survival advantage. 29,30 The addition of anthracyclines has not improved the response rate or duration of the response, 31,32 but its use may be associated with a lower risk of histologic transformation. 16,33 This finding has to be confirmed, particularly in the era of chemoimmunotherapy.…”

Prognostic factors in non-Hodgkin's lymphoma: The importance of symptomatic stage as an adjunct to the Kiel histopathological classification

“…Patients with low grade lymphoma and B symptoms will require active intervention. However, long-term results in this group with both combination and single agent chemotherapy have been disappointing (Portlock et al, 1976;McKelvy & Moon, 1977;Lister et al, 1978). Patients with disseminated high grade lymphoma all require aggressive treatment as their disease is potentially curable (DeVita et al, 1975;Berd et al, 1975;McKelvy & Moon, 1977 …”