The F-MACHOP sequential combination chemotherapy regimen in advanced diffuse aggressive lymphomas: long-term results.
The present study reports the long-term results of the F-MACHOP sequential combination chemotherapy regimen in 113 adult patients with advanced stages of diffuse large-cell or undifferentiated lymphoma who were consecutively treated with this regimen from January 1980 to December 1986 at a single institution. The CR rate was 78% and 17 relapses were observed, so that 80% of CR patients are expected to be free of relapse at 5 and 10 years after a median follow-up off-therapy of 5.7 years (range 3.2-10.1). Projected survival and event-free survival at 8 years are 68% and 62%, respectively. Prognostic factor analysis indicates that the CR rate was influenced by systemic symptoms and number of extranodal sites, disease-free survival by tumor burden and number of courses to achievement of CR, event-free survival and survival by tumor mass diameter, systemic symptoms and number of extranodal sites. Toxicity was mainly hematological, and 3 patients (3%) died while severely neutropenic. The rapidity of response appears to have prognostic value, particularly in patients presenting with high tumor burden, in whom achievement of a CR within 3 courses indicates a group of patients with a very high chance of cure with this regimen.
Guglielmi
C
C
Department of Human Biopathology, University La Sapienza, Roma, Italy.
Amadori
S
S
Martelli
M
M
Dragoni
F
F
Mandelli
F
F
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002985:Clinical Protocols; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D005472:Fluorouracil; D011241:Prednisone; D008727:Methotrexate