Results of a Prospective Study of High-Dose or Conventional Anthracycline-Cyclophosphamide Regimen Plus Radiotherapy for Localized Adult Non-Hodgkin's Primary Bone Lymphoma.
Background. Primary bone lymphoma (PBL) is a rare entity that has only been reviewed in one prospective and small retrospective studies, from which it is difficult to establish treatment guidelines. We prospectively evaluated high-dose or conventional anthracycline-cyclophosphamide dose and radiotherapy for PBL. Patients and Methods. The GOELAMS prospective multicenter study (1986-1998) enrolled adults with localized high-grade PBL according to age and performance status (PS). Patients <60 years received a high-dose CHOP regimen (VCAP) and those ≥60 years a conventional anthracycline-cyclophosphamide regimen (VCEP-bleomycin); all received intrathecal chemotherapy and local radiotherapy. Results. Among the 26 patients included (VCAP: 19; VCEP-bleomycin: 7), 39% had poor PS ≥2. With a median follow-up of 8 years, overall survival, event-free survival, and relapse-free survival were 64%, 62%, and 65%, respectively, with no significant difference between treatment groups. Poor PS was significantly associated with shorter OS and EFS. Conclusions. Our results confirm the efficacy of our age-based therapeutic strategy. High-doses anthracycline-cyclophosphamide did not improve the outcome. VCEP-bleomycin is effective and well tolerated for old patients. The intensification must be considered for patients with PS ≥2, a poor prognostic factor.
Hematology Department of the University of Angers, Angers, France.
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A
Schmidt-Tanguy
Hematology Department of the University of Rennes, Rennes, France.
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R
Houot
Hematology Department of the University of Tours, Tours, France.
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Lissandre
Hematology Department of the University of Brest, Brest, France.
J F
JF
Abgrall
Hematology Department of the University of Bobigny, Bobigny, France.
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Casassus
Hematology Department of the Hospital of Blois, Blois, France.
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Rodon
Hematology Department of the University of Amiens, Amiens, France.
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Desablens
Hematology Department of the University of Amiens, Amiens, France.
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JP
Marolleau
Hematology Department, St. Quentin General Hospital, St. Quentin, France.
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R
Garidi
Hematology Department of the University of Rennes, Rennes, France.
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Lamy
Hematology Department of the University of Angers, Angers, France.
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MP
Moles-Moreau
Hematology Department of the University of Amiens, Amiens, France ; University Hospital of Amiens, Department of Clinical Haematology, Avenue Laennec, 80054 Amiens, France.
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Damaj