Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-Hodgkin's lymphomas Journal Article

  

Authors:	Schneider, A. M.; Straus, D. J.; Schluger, A. E.; Lowenthal, D. A.; Koziner, B.; Lee, B. J.; Wong, G.; Clarkson, B. D.
Article Title:	Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-Hodgkin's lymphomas
Abstract:	Seventy previously untreated patients with stage II, III, and IV intermediate- or high-grade lymphoma were treated with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) between September 1985 and November 1987. Forty-nine of these patients had diffuse large-cell lymphoma (DLCL), and eight of these patients were human immunodeficiency virus (HIV)-positive. Complete responses were achieved in 54% of all patients and 52% of those with DLCL. With follow-up extending to 36 months, 45% of all DLCL patients are alive, and 50% are still living, if the HIV-positive patients are excluded from the analysis. Chemotherapy was quite toxic. Seventy-five percent of patients had severe mucositis, 42% had peripheral neuropathy, 50% required hospitalization, and 54% experienced leukopenia with a WBC count below 1,000/μL. Seven percent (five patients) died of toxicity related to the chemotherapy. Our analysis of prognostic parameters indicated that B symptoms, a performance status below 80, and, to a lesser extent, elevation of serum lactic acid dehydrogenase (LDH) (in HIV-negative DLCL patients) were associated with an inferior survival. Advanced age, sex, and bulky disease were not found to have a statistically significant effect on survival. Our preliminary results indicate that MACOP-B chemotherapy is an effective regimen for high- and intermediate-grade lymphomas. However, the survival for patients with DLCL treated with MACOP-B is no different than that achieved with previous regimens at our institution. © 1990 by American Society of Clinical Oncology.
Keywords:	adolescent; adult; aged; major clinical study; prednisone; doxorubicin; comparative study; methotrexate; follow-up studies; neoplasm staging; antineoplastic combined chemotherapy protocols; cyclophosphamide; vincristine; time factors; nonhodgkin lymphoma; randomized controlled trials; lymphoma, non-hodgkin; remission induction; bleomycin; human immunodeficiency virus; bone marrow transplantation; leucovorin; intravenous drug administration; middle age; hiv seropositivity; prognosis; human; male; female; priority journal; article; ethnic or racial aspects
Journal Title:	Journal of Clinical Oncology
Volume:	8
Issue:	1
ISSN:	0732-183X
Publisher:	American Society of Clinical Oncology
Date Published:	1990-01-01
Start Page:	94
End Page:	102
Language:	English
DOI:	10.1200/jco.1990.8.1.94
PUBMED:	1688617
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0025162172&doi=10.1200%2fJCO.1990.8.1.94&partnerID=40&md5=947a6760fa619d4773d1a37de02d5137
Notes:	Source: Scopus

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