Long-term survival advantage of MACOP-B over CHOP in intermediate-grade non-Hodgkin's lymphoma

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Abstract
Background The initial publication of the results of the Australian and New Zealand Lymphoma Group (ANZLG) randomized controlled trial comparing MACOP-B and CHOP in patients with intermediate-grade non-Hodgkin's lymphoma (NHL) showed equivalent complete response rates, time to treatment failure, and survival. Here we report the long-term follow-up of the 236 patients entered on that study to determine if there were any long-term advantages or disadvantages associated with MACOP-B. Patients and methods Two hundred thirty-six eligible patients were randomized between October 1986 and June 1991. The median duration of follow-up has been extended from 3.2 years in our previous publication to 6.5 years. Results As previously reported, the complete response (CR) rate for MACOP-B and CHOP chemotherapy was 51% and 59%, respectively. The estimated failure-free survival rate for MACOP-B and CHOP patients was 42% and 30%, respectively, at 5 years ( P = 0.045) and 37% and 25%, respectively, at 8 years ( P = 0.057). The estimated overall survival rate at 5 years was 54% for MACOP-B and 41% for CHOP patients ( P = 0.035) and at 8 years was 45% and 36%, respectively (P = 0.16). Conclusions With this extended follow-up, we have shown a long-term survival advantage for MACOP-B chemotherapy over standard CHOP in patients with intermediate-grade non-Hodgkin's lymphoma.