Fludarabine alone compared to CHVP plus interferon in elderly patients with follicular lymphoma and adverse prognostic parameters: A GELA study

Abstract

CHVP plus interferon over 18 months was associated with a better outcome, even though the combination of interferon plus chemotherapy was less well tolerated than fludarabine.

Fludarabine, mitoxantrone, dexamethasone (FND) compared with an alternating triple therapy (ATT) regimen in patients with stage IV indolent lymphoma

“…Single-agent fludarabine is effective, inducing remission in 65% (CR, 37%) of 42 previously untreated patients, 26 although it may be inferior to a combination chemotherapy regimen, such as CHVP (cyclophosphamide, doxorubicin, teniposide, prednisone). 27 Many investigators have used fludarabine in combination regimens, most often with mitoxantrone (with or without steroids) or cyclophosphamide. With FND and variants, response rates of 69% to 84% have been reported, mostly in the setting of relapse, but also in the front-line setting.…”

“…Other factors (14) 5 (7) High ␤2-microglobulin 20 (27) 11 (16) Bulky 36 (49) 39 (57) PS indicates performance status; LDH, lactate dehydrogenase. (20) 9 (12) 19 (28) PR (%) 20 (14) 13 (18) 7 (10) SD (%) 1 (1) 0 (0) 1 (1.5)…”

Rituximab combined with chemotherapy and interferon in follicular lymphoma patients: results of the GELA-GOELAMS FL2000 study

“…7 Long-term results of the GELF86 study, which evaluated a low-dose anthracycline combination chemotherapy regimen given for 12 courses over 18 months with interferon, indicate that this combination produces long-term remissions. 8 This regimen was not found to be inferior to other approaches, such as fludarabine alone 9 or myeloablative therapy supported with autologous stem cell transplantation. 10,11 However, no chemotherapy regimen, with or without interferon, for first-line therapy of follicular lymphoma patients has been clearly established as a standard regimen worldwide.…”

Standard chemotherapy with interferon compared with CHOP followed by high-dose therapy with autologous stem cell transplantation in untreated patients with advanced follicular lymphoma: the GELF-94 randomized study from the Groupe d'Etude des Lymphomes de l'Adulte (GELA)

“…High tumor burden was defined by at least one of the following parameters using Groupe d'Etude des Lymphomas Folliculaires (GELF) criteria: systemic symptoms (Ͼ 10% weight loss, temperature Ն 38°C for more than 5 days, abundant night sweats); performance status (PS) greater than 1 according to the Eastern Cooperative Oncology Group (ECOG) scale; elevated lactate dehydrogenase (LDH) level; ␤2-microglobulin level greater than 25.5 nM/L (3 g/mL); a single lymph node larger than 7 cm; marked splenomegaly; organ failure; pleural effusion or ascites; orbital or epidural involvement; blood infiltration; or cytopenia. [14][15][16] Exclusion criteria were as follows: previous treatment for lymphoma; diagnosis more than 3 months before; blood creatinine level above 150 M; history of another cancer except in situ breast cancer or uterine cancer; contraindication to doxorubicin, interferon, or intensive therapy; positive serologic test for the human immunodeficiency virus; or histologic transformation into a more aggressive lymphoma. This study complied with the Declaration of Helsinki and its current amendments and was conducted in accordance with Good Clinical Practice guidelines.…”