Non-Hodgkin's lymphoma of unfavourable histology: a multivariate analysis of factors predicting the response to CHOP.
Forty-eight patients with de novo non-Hodgkin's lymphoma (NHL) of unfavourable biology received CHOP as first-line chemotherapy. A complete remission (CR) was achieved in 64.5 per cent patients. Overall 4-year projected survival was 48 per cent with a median follow-up of 40.5 months. Two pretreatment characteristics, high LDH serum levels and bulky abdominal disease, were negatively associated with survival at the proportional hazards regression model and were used to calculate each patient's relative-risk. Such analysis allowed to identify two prognostic subgroups according to their outcome to CHOP. Firstly, a high-risk subgroup that showed an 8 per cent CR rate, most patients dying within the first year after diagnosis. Secondly, a low-risk subgroup that showed an 83.5 per cent CR rate and a 4-year project survival of 66 per cent. From the above results two major conclusions can be drawn: (1) the CHOP combination is an effective treatment for unfavourable NHL patients with a low relative-risk and (2) new therapeutic approaches should be explored for NHL patients with a high relative-risk at diagnosis.
D000328:Adult; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy / Q000201:enzymology / Q000473:pathology*; D008297:Male; D008433:Mathematics; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D014750:Vincristine / Q000627:therapeutic use
D007527:Isoenzymes; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D007770:L-Lactate Dehydrogenase; D011241:Prednisone