[Treatment of aggressive lymphomas].
The age-adjusted International Prognostic Index (IPI) allows the definition of clinically relevant subgroups in younger patients (< or = 60 years) with aggressive lymphomas. Six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisone-21 (CHOP-21) with rituximab (R-CHOP-21) achieved an event free survival after 3 years of > 90% in patients with a very good prognosis (IPI 0, without bulk). In contrast, in patients from the less favourable groups (all IPI 1, IPI 0 with bulk only), the same therapy resulted in an event-free survival at 3 years of less than 80%. This requires improvement. Young patients with a worse risk profile have a survival probability of 60% after 5 years. Dose dense therapeutic regimens and autologous stem cell transplantation are being applied to this patient group in clinical trials. For patients > 60 years, the advantage of combined immunochemotherapy has been clearly documented. For patients > 60 years from all IPI groups, the best results have so far been achieved with six courses of R-CHOP-14 followed by two additional applications of rituximab.
Gleissner
B
B
Medizinische Klinik I, Universitätsklinikum Saarland, Kirrberger Strasse, 66421, Homburg, Deutschland.
Zwick
C
C
Pfreundschuh
M
M
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D008223:Lymphoma / Q000145:classification* / Q000628:therapy*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends; D011241:Prednisone / Q000627:therapeutic use; D016499:Radioimmunotherapy / Q000379:methods* / Q000639:trends*; D014750:Vincristine / Q000627:therapeutic use
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone