Advanced Non-Hodgkin's Lymphomas: Response to Treatment with Combination Chemotherapy and Factors Influencing Prognosis

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Abstract
Response to combination chemotherapy with cyclophosphamide, vincristine and prednisone (COP) and specific factors influenceing prognosis were evaluated in 70 patients with stage III or IV non-Hodgkin's lymphomas. Complete remissions (CR) were observed in 40% of patients, with a total response rate of 88%. The median duration of CR was 8 months, but 50% of patients were in continuing CR. High rates of CR were associated with: (a) well-differentiated lymphocytic cytology, (b) tumour nodularity, (c) normal blood lymphocyte counts at diagnosis, and (d) disease stage IIIA. These same factors also showed a positive correlation with 5-year-survival rates from diagnosis. It is suggested that patients with advanced non-Hodgkin's lymphomas do not form a homogeneous treatment group, but warrant a differential therapeutic approach based on the prognostic determinants stated above. The study provides further support for the prognostic usefulness of Rappaport's classification of these tumours.