ADVANCED DIFFUSE HISTIOCYTIC LYMPHOMA TREATED WITH CYCLOPHOSPHAMIDE, DOXORUBICIN, VINCRISTINE, AND PREDNISONE (CHOP) WITHOUT MAINTENANCE THERAPY

  • 1 January 1980
    • journal article
    • research article
    • Vol. 64  (4-5) , 649-654
Abstract
Patients (31) with stage III or IV diffuse histiocytic lymphoma were treated with cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) at 3 or 4 wk intervals for at least 6 cycles or until 2 cycles after complete remission (CR) was achieved. At the completion of therapy, CR was documented by examination of sites known to previously contain disease. After documentation of CR, patients were followed without maintenance therapy. Fifteen patients (48%) achieved CR, 4 (13%) had equivocal lymphangiograms on restaging but were otherwise free of disease, 2 (6%) died of unrelated causes during therapy, 2 (6%) developed CNS lymphoma during therapy and despite peripheral remission eventually died of the CNS disease, and 8 (26%) had partial or no response. Twelve of the 15 patients achieving CR remain disease-free with no therapy for 9+ to 43+ mo. Three patients relapsed at 3, 4 and 23 mo. after discontinuation of therapy. Three of the 4 patients with equivocal restaging lymphangiograms remain without progressive disease with no therapy for 10+ to 24+ mo. The projected median survival time for all patients is 41 mo. The risks of long-term (maintenance) chemotherapy are considerable and include the induction of acute nonlymphoblastic leukemia. CHOP without maintenance therapy is able to induce long-term disease-free survival (and probable cure) in a significant number of patients with advanced diffuse histiocytic lymphoma.