EFFECTIVE TREATMENT OF SMALL-NONCLEAVED-CELL LYMPHOMA WITH HIGH-INTENSITY, BRIEF-DURATION CHEMOTHERAPY

被引:79
作者
MCMASTER, ML [1 ]
GREER, JP [1 ]
GRECO, FA [1 ]
JOHNSON, DH [1 ]
WOLFF, SN [1 ]
HAINSWORTH, JD [1 ]
机构
[1] VANDERBILT UNIV, DIV MED ONCOL, NASHVILLE, TN 37240 USA
关键词
D O I
10.1200/JCO.1991.9.6.941
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Small-noncleaved-cell (SNC) lymphoma is a high-grade, biologically aggressive neoplasm notable for poor response to therapy, high relapse rate, and less than a 20% long-term survival. We treated 20 patients with SNC lymphoma with a novel chemotherapeutic regimen using intensive doses of chemotherapy at frequent intervals in the inpatient setting. All patients were previously untreated. Sixteen patients (80%) had stage IV disease. Most patients (95%) had at least one other characteristic associated with poor prognosis (bulky [> 10 cm] disease, multiple extranodal sites, poor performance status), and 85% had two or more characteristics associated with poor prognosis. Seventeen patients (85%) achieved a complete response (CR) to therapy, including all three patients with human immunodeficiency virus (HIV)-associated disease. There have been three relapses, all occurring less than 18 months after treatment, and two of three relapses occurred in patients who were unable to complete therapy. At a median follow-up of 29 months, 13 patients (65%) remain disease-free; the calculated 5-year actuarial disease-free survival is 60%. Toxicity, chiefly myelosuppression, was severe but manageable. There were two treatment-related deaths, both in elderly patients with poor performance status and advanced-stage disease. These data suggest that such a dose-intensive approach improves the response and survival of patients with SNC lymphoma. © 1991 by American Society of Clinical Oncology.
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页码:941 / 946
页数:6
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