title: Comparison of two high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone derived regimens in patients aged under 60 years with low-intermediate risk aggressive lymphoma: a final analysis of the multicenter LNH93-2 protocol.
abstract: One-third of patients aged <or=60 years with aggressive lymphoma are at low-intermediate risk (LIR). Before the rituximab era, we prospectively compared ACVBP with ECVBP, a similar regimen including epirubicin instead of doxorubicin and increased dose intensity of cyclophosphamide, followed by conventional consolidation with an increased amount and dose intensity of cytosine-arabinoside, methotrexate, etoposide, and ifosfamide, in 652 patients with LIR aggressive lymphoma. The overall response rate, 5-year event-free survival (EFS), and survival were estimated to be 86%, 60%, and 74%, respectively, with no differences between the two arms. In patients with diffuse large B-cell lymphoma (DLBCL) who received ACVBP, the 5-year EFS and survival were estimated at 69% and 82%. These findings do not support the use of a chemotherapy regimen more intensive than ACVBP in patients aged <or=60 years with LIR aggressive lymphoma. The results in the control arm, without rituximab, have led to a randomized comparison of R-ACVBP and R-CHOP in this patient population.
authors.affiliation: Service d'Hématologie Clinique, Centre Hospitalier Schaffner, Lens, France. pmorel@ch-lens.fr
authors.forename: Pierre
authors.initials: P
authors.lastname: Morel
authors.forename: Jean-Nicolas
authors.initials: JN
authors.lastname: Munck
authors.forename: Bertrand
authors.initials: B
authors.lastname: Coiffier
authors.forename: Christian
authors.initials: C
authors.lastname: Gisselbrecht
authors.forename: Dana
authors.initials: D
authors.lastname: Ranta
authors.forename: Andre
authors.initials: A
authors.lastname: Bosly
authors.forename: Hervé
authors.initials: H
authors.lastname: Tilly
authors.forename: Bruno
authors.initials: B
authors.lastname: Quesnel
authors.forename: Antoine
authors.initials: A
authors.lastname: Thyss
authors.forename: Nicolas
authors.initials: N
authors.lastname: Mounier
authors.forename: Josette
authors.initials: J
authors.lastname: Brière
authors.forename: Thierry
authors.initials: T
authors.lastname: Molina
authors.forename: Felix
authors.initials: F
authors.lastname: Reyes
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001761:Bleomycin / Q000008:administration & dosage; D003520:Cyclophosphamide / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009367:Neoplasm Staging; D011241:Prednisone / Q000008:administration & dosage; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D014751:Vindesine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D003561:Cytarabine; D001761:Bleomycin; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D014751:Vindesine; D007069:Ifosfamide; D011241:Prednisone; D008727:Methotrexate