MACOP-B Chemotherapy for the Treatment of Diffuse Large-Cell Lymphoma

Klimo, Paul

doi:10.7326/0003-4819-102-5-596

Cited by 620 publications

(154 citation statements)

References 11 publications

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“…The use of anthracycline-based four-drug chemotherapy regimens such as CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) has resulted in long-term diseasefree survival for a substantial minority of patients (McKelvey et al, 1975;Coltman et al, 1986), whilst more complex and toxic regimens using larger numbers of drugs have been apparently more effective when judged against historical controls (Schein et al, 1976;Laurence et al, 1982;Fisher et al, 1983;Skarin et al, 1983;Klimo & Connors, 1985). The results with such regimens used at different institutions have however rarely matched those of their originators (Schneider et al, 1990;Weick et al, 1991) and phase III trials of direct comparison have failed to demonstrate a clear advantage for the more complex treatments (O'Connell et al, 1984;Gordon et al, 1989).…”

Section: Resultsmentioning

confidence: 99%

“…In almost two decades since the initial reports of long-term disease free survival after chemotherapy for the diffuse aggressive lymphomas (Levitt et al, 1972;De Vita et al, 1975) a variety of newer, more complex and more toxic regimens have been described which are said to improve remission rates and survival (Schein et al, 1976;Laurence et al, 1982;Fisher et al, 1983;Skarin et al, 1983;Klimo & Connors, 1985). The evaluation of such claims is however made difficult by the heterogeneity of the patient populations studied and lack of a well recognised set of prognostic factors.…”

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confidence: 99%

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β-2 microglobulin: a prognostic factor in diffuse aggressive non-Hodgkin's lymphomas

Johnson

Whelan²,

Longhurst³

et al. 1993

Br J Cancer

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beta-2 microglobulin levels were measured in stored serum taken at presentation from 262 patients treated with combination chemotherapy for Kiel classification high-grade lymphoma at a single centre over a 15 year period. A significant association was found between elevated levels and advanced (Ann Arbor stage III or IV) disease or hepatic infiltration, but not with other sites of extranodal involvement or bulky disease. Patients with normal levels at presentation had a 70% remission rate with treatment compared to 37% of those with elevated levels (P < 0.001). With median follow up of 6 years duration of remission was significantly greater in patients with normal beta-2 microglobulin at presentation (plateau at 70%, compared to median remission of 19 months in those with raised levels, P < 0.001). Survival overall was also better in the group with normal levels (actuarial median 9 years compared to 1 year, P < 0.001). Multivariate analyses including treatment type, age, sex, B symptoms, stage, bulk, albumin, sodium, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase and beta-2 microglobulin, placed beta-2 microglobulin among the three most influential independent variables for prediction of response rate, duration of remission and overall survival.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

β-2 microglobulin: a prognostic factor in diffuse aggressive non-Hodgkin's lymphomas

Johnson

Whelan²,

Longhurst³

et al. 1993

Br J Cancer

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“…Patients with ATL have been treated by various agents and schedules, such as VEPA (Shimoyama et al, 1988b), CHOP (McKelvey et al. 1976) and MACOP-B (Klimo et al. 1985).…”

Section: Patientsmentioning

confidence: 99%

Treatment of adult T-cell leukaemia–lymphoma with irinotecan hydrochloride (CPT-11)

Tsuda

Takatsuki²,

Ohno³

et al. 1994

Br J Cancer

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Summan A late phase I1 study of a new camptothecin analogue. inrnotecan hydrochloride (CPT-l1). was conducted to evaluate the anti-tumour effect and toxicity in patients with refractory leukaemia and lymphoma including adult T-cell leukaemia (ATL)-lymphoma. in a multi-institutional cooperative study. All the patients with ATL had been previously treated with various conventional combination chemotherapies and were refractonr to these therapies or had relapsed. CPT-1 1 was administered at a dose of 40 mg m-day -' for three consecutive days repeated weekly until eVidence of disease progression. One complete remission and four partial remissions were achieved in 13 assessable patients with ATL. The median total dose to achieve remission was 240 mg m and the median duration of response was 31 days. The major toxicities were leucopenia (83%). diarrhoea (62%) and nausea vomiting (69%). These were relatively severe. but they were generally tolerable and reversible. However. one patient died probably as a result of this therapy. No effective chemotherapy for adult T-cell leukaemia-lymphoma has yet been established, and the prognosis for patients with this disease is very poor. Our results suggest that CPT-l1 may be a promising agent for this disease. Further combination therapy with CPT-11 is needed to improve the therapy for ATL.

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“…Patients with aggressive NHL were submitted to the MACOP-B regimen (Klimo and Connors, 1985). Radiotherapy was performed at the clinician's discretion.…”

Section: Induction Treatmentmentioning

confidence: 99%

Predictive role of positron emission tomography (PET) in the outcome of lymphoma patients

et al. 2004

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An extensive analysis of the reliability of positron emission tomography (PET) after induction treatment in patients with Hodgkin's disease (HD) or aggressive non-Hodgkin's lymphoma (NHL). In all, 75 untreated patients with HD (n ¼ 41) or aggressive NHL (n ¼ 34) were studied with both PET and CT scans following standard chemotherapy induction therapy (ABVD or MACOP-B) with/ without radiotherapy. Histopathological analysis was performed when considered necessary. After treatment, four out of five (80%) patients who were PET þ /CT À relapsed, as compared with zero out of 29 patients in the PET À /CT À subset. Among the 41 CT þ patients, 10 out of 11 (91%) who were PET þ relapsed, as compared with 0 out of 30 who were PET À . The actuarial relapse-free survival (RFS) rates were 9 and 100% in the PET þ and PET À subsets, respectively (P ¼ 0.00001). All five patients who were PET þ / CT À underwent a lymph node biopsy: in four (80%) cases, persistent lymphoma and was confirmed at histopathological examination. Two HD patients who were PET À /CT þ (with large residual masses in the mediastinum or lung) were submitted to biopsy, which in both cases revealed only fibrosis. In HD and aggressive NHL patients, PET positivity after induction treatment is highly predictive for the presence of residual disease, with significant differences being observable in terms of RFS. PET negativity at restaging strongly suggests the absence of active disease; histopathological verification is important in patients who show PET positivity.

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MACOP-B Chemotherapy for the Treatment of Diffuse Large-Cell Lymphoma

Cited by 620 publications

References 11 publications

β-2 microglobulin: a prognostic factor in diffuse aggressive non-Hodgkin's lymphomas

β-2 microglobulin: a prognostic factor in diffuse aggressive non-Hodgkin's lymphomas

Treatment of adult T-cell leukaemia–lymphoma with irinotecan hydrochloride (CPT-11)

Predictive role of positron emission tomography (PET) in the outcome of lymphoma patients

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