title: The COP-BLAM programs: evolving chemotherapy concepts in large cell lymphoma.
abstract: The cyclophosphamide, vincristine, prednisone, bleomycin, doxorubicin, procarbazine (COP-BLAM) programs of combination chemotherapy were administered to patients with advanced diffuse large cell lymphoma. The original COP-BLAM programs were designed to deliver intense multidrug therapy maximizing tumor kill. COP-BLAM programs IA and IB, easily administered on an outpatient basis, produced identical 73% complete remissions (CRs) and 55% long-term, disease-free survival (DFS). COP-BLAM III, an outgrowth of studies using infusional therapy, differed from COP-BLAM by using infusional bleomycin and vincristine alternated with bolus vincristine. With COP-BLAM III, 84% CRs, 76% "potential cures," and a 65% DFS were produced at a median follow-up time of 50 months. COD-BLAM IV, using four sequential cycles of infusional chemotherapy, high-dose alternating myelosuppressives (doxorubicin, cyclophosphamide), and cycle-active agents (methotrexate, cytarabine, and etoposide) produced 88% CRs, 67% potential cures, and a 64% DFS at a median follow-up of 24 months. COP-BLAM V employs four to six sequential cycles of infusional chemotherapy tailored to the rapidity of response. Preliminary results in patients with high-risk Hodgkin's disease suggest COP-BLAM V may be effective despite the shortened treatment time. In all programs, prognostic factors were critical determinants in the results achieved, particularly age and rapidity of response.
authors: Division of Hematology-Oncology, New York Hospital-Cornell Medical Center, NY 10021.
authors: M
authors: M
authors: Coleman
authors: J O
authors: JO
authors: Armitage
authors: M
authors: M
authors: Gaynor
authors: D
authors: D
authors: McDermott
authors: D D
authors: DD
authors: Weisenburger
authors: K
authors: K
authors: Adler
authors: M
authors: M
authors: Beshevkin
authors: R T
authors: RT
authors: Silver
authors: A M
authors: AM
authors: Reisman
authors: M W
authors: MW
authors: Pasmantier
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004341:Drug Evaluation; D006801:Humans; D007262:Infusions, Intravenous; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011344:Procarbazine / Q000008:administration & dosage / Q000009:adverse effects; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D001761:Bleomycin; D011344:Procarbazine; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone