[Comparison of chemotherapy CHOP vs. CHOP/VIA in the treatment of aggressive non-Hodgkin's lymphoma: a randomized multicenter study of 132 patients. The PETHEMA group. Program for Study and Therapeutics of malignant hemopathies. Spanish Association of Hematology and Hemotherapy].
BACKGROUND
To compare standard chemotherapy CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) with the regimen CHOP/VIA (VP-16, iphosphamide and cytarabine) in terms of response to therapy, response duration, survival and toxicity in patients with aggressive lymphoma.


METHODS
132 patients (84 males and 48 females; median age, 55 years) were included from 12 Spanish Institutions, diagnosed of non-Hodgkin's lymphoma of intermediate or high grade, in stages II-IV and previously untreated. Patients were randomized to receive CHOP or CHOP/VIA.


RESULTS
After excluding 14 not assessable cases, 62 patients (52.5%) received CHOP, and 56 (47.5%) CHOP/VIA. No significant differences were found on main prognostic factors between such groups. Response was assessable in 114 cases (CHOP: 61; CHOP/VIA: 53) 39 patients (64%) receiving CHOP achieved complete response (CR), and 2 (3%) partial response (PR), whereas in the CHOP/VIA group CR and PR rates were 63% (34/53), and 7% (4/53), respectively. 14 patients (36%) treated with CHOP and 12 (35%) treated with CHOP/VIA eventually relapsed, with an actuarial risk of relapse at 36 months of 43% and 40%, respectively. Median survival was 37 months. No differences were found between both therapeutic groups, with an overall survival at 36 months from diagnosis of 53.5% (CI 95%: 40-67) for CHOP and 48% (CI 95%: 34-62) for CHOP/VIA. Finally, toxicity was not different for both arms.


CONCLUSIONS
In the present study in patients with aggressive NHL chemotherapy regimens CHOP and CHOP/VIA showed similar results in terms of response, response duration, survival and toxicity.
López-Guillermo
A
A
Servicio de Hematología, Hospital Clínic i Provincial, Villarroel, Barcelona.
García-Conde
J
J
Alvarez-Carmona
A M
AM
León
P
P
Maldonado
J
J
Alcalá
A
A
Zubizarreta
A
A
Sancho-Tello
R
R
Carbonell
F
F
Contreras
E
E
Besses
C
C
Hernando
A
A
Fontanillas
M
M
Montserrat
E
E
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003627:Data Interpretation, Statistical; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008224:Lymphoma, Follicular / Q000188:drug therapy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy; D016400:Lymphoma, Large-Cell, Immunoblastic / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage
D003561:Cytarabine; D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D007069:Ifosfamide; D011241:Prednisone
Comparación de la quimioterapia CHOP frente a CHOP/VIA para el tratamiento de los linfomas no hodgkinianos agresivos: estudio multicéntrico aleatorizado en 132 pacientes. Grupo PETHEMA. Programa para el Estudio y la Terapéutica de las Hemopatías Malignas. Asociación Española de Hematología y Hemoterapia.