NODULAR MIXED LYMPHOMA - RESULTS OF A RANDOMIZED TRIAL FAILING TO CONFIRM PROLONGED DISEASE-FREE SURVIVAL WITH COPP CHEMOTHERAPY

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  • 1 January 1981
    • journal article
    • research article
    • Vol. 58  (5) , 920-925
Abstract
Patients (52) with stage III or IV nodular mixed lymphocytic-histiocytic lymphoma (NM) were entered in a prospective randomized trial comparing cyclophosphamide-prednisone (CP) to COPP (cyclophosphamide, vincristine, procarbazine, prednisone) or BCVP (BCNU [1,3-bis-(2-chloroethyl)-1-nitrosourea], cyclophosphamide, vincristine, prednisone). The COPP regimen utilized in this Eastern Cooperative Oncology Group (ECOG [USA]) trial was similar to the 4-drug regimen C-MOPP [cyclophosphamide, nitrogen mustard, vincristine, procarbazine, prednisone] reported by the National Cancer Institute [USA] to achieve prolonged relapse-free survival in this histology. No significant differences in complete response rates, response duration or overall survival were noted among the 3 regimens. A pattern of continuous late relapse was observed for all 3 chemotherapy programs. Although 11 of the 18 (61%) COPP patients achieved a complete response, only 3/11 (27%) remain disease-free with a median follow-up of > 3 yr. Two of these 3 long-term complete responders have died with no clinical evidence of recurrent disease. The COPP patients received 84% of the calculated ideal doses of cyclophosphamide and 78% of the ideal dosage of procarbazine. Grade 3-4 hematologic toxicity was noted in 22% of the COPP group, 36% with BCVP and 0% for the CP patients. The ability of COPP to achieve durable complete remissions in NM lymphoma was not confirmed. The CP combination was equally effective when compared with COPP and BCVP, but produced minimal toxicity.