[Treatment of aggressive non Hodgkin's lymphoma: the experience of a general hospital].
OBJECTIVE
The LNH84 regimen for aggressive non Hodgkin's lymphoma consists in an intensive induction phase followed by a consolidation phase. The objectives of this study are to evaluate the feasability and activity of a modified induction phase of this regimen in an oncologic department of a general university hospital.


METHODS
Twenty-eight consecutive patients receive three or four induction courses of CDBVP corresponding to intravenous cyclophosphamide (C), doxorubicin (D), bleomycin (B), vincristine (V) and oral prednisone (P), for a total of 89 courses. Median age is 42 years and 18 patients are male. IWF is F to J. Fourteen have B symptoms, five a bulky disease, 18 abnormal LDH and nine bone marrow involvement.


RESULTS
After the induction phase, 12 patients achieve CR and 11 PR for an overall response rate of 92%. Toxicity consists in severe myelosuppression with a neutropenia WHO grade 4 in all patients. The interval between courses is lengthened for each period, with a median interval of 18.5 days between cycle 1 and 2, 19.5 days between cycle 2 and 3 and 22 days between cycle 3 and 4. Eight patients present an infection WHO grade 3 and one patient died of a treatment related pulmonary complication. At 3 years the overall survival and event free survival is 78% and 57% respectively.


CONCLUSIONS
In our experience, the CDBVP protocole is a toxic regimen difficult to administer in a general hospital. Its administration out of a protocole can not be recommanded for good prognosis patients. Its interest for poor prognosis patients should be evaluated with clinical studies.
Laurencet
F M
FM
Division d'oncologie, hôpitaux universitaires de Genève, Suisse.
Zulian
G B
GB
Dietrich
P Y
PY
Anchisi
S
S
Mermillod
B
B
Alberto
P
P
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D001853:Bone Marrow / Q000187:drug effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006769:Hospitals, General; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D016019:Survival Analysis; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D014751:Vindesine / Q000008:administration & dosage
D001761:Bleomycin; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone; D014751:Vindesine; D011241:Prednisone
Traitement des lymphomes non hodgkiniens agressifs: expérience d'un hôpital général.