[Recent progress in the treatment of malignant lymphoma].
Recent progress in the chemotherapy for malignant lymphoma is reviewed. From the viewpoint of treatment, malignant lymphoma is classified into five major categories; aggressive lymphoma, indolent B-lymphoma, Hodgkin's disease, T-lymphoblastic lymphoma and adult T-cell leukemia-lymphoma (ATL). Based on the results of the clinical chemotherapy trials conducted by the cooperative oncology groups in Western countries and the Lymphoma Study Group (LSG) in Japan, the state of the art of chemotherapy for malignant lymphoma is described. In aggressive lymphoma of advanced stages, after establishment of CHOP therapy (first generation), better results were reported in the United States for single institute single-arm studies of non-cross resistant alternating multiagent chemotherapy (second generation) and high relative dose intensity chemotherapy (third generation). However, recent multicenter phase III studies, comparing CHOP with third generation regimens, revealed that CHOP remains the best available treatment, because of similar failure-free and overall survival with lower cost and lower severe toxicity. More recently, the results of the International Non-Hodgkin's Lymphoma Prognostic Factors Project were reported. Based on the number of the five unfavorable factors present, such as age, stage, LDH, performance status and the number of extranodal disease sites, a new predictive model "international index" for aggressive lymphoma was developed. Such predictive models based on prognostic factor analyses would be very useful in the design of future clinical trials in patients with aggressive lymphoma and in the selection of appropriate therapeutic approaches for individual patients.
Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
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Tobinai
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Shimoyama
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000188:drug therapy; D016393:Lymphoma, B-Cell / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000532:radiotherapy; D016399:Lymphoma, T-Cell / Q000188:drug therapy; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D014750:Vincristine / Q000008:administration & dosage
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone