title: The Effect of Intensified Induction Using Vanderbilt Regimen in Patients with an Intermediate Grade Non-Hodgkin's Lymphoma Having 2 or 3 Adverse Factors on the Age-adjusted International Prognostic Index.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the outcome of intensified induction therapy using the Vanderbilt regimen in patients with a poor prognosis non-Hodgkin's lymphoma (NHL).
  
  
  METHODS
  We retrospectively analyzed the results of two pilot studies, which enrolled the patients aged 60 years or less, with a previously untreated NHL of intermediate grade on the Working formulation, having 2 or 3 adverse prognostic factors on the age- adjusted International Prognostic Index. Patients received an intensified induction, with the regimen described by the Vanderbilt group.
  
  
  RESULTS
  Thirty-five patients were analyzed. After induction, 29 patients (83%) achieved more than partial response (PR): 22 (63%) complete response (CR) and 7 (20%) PR. Three of the PRs were subsequently converted to CR following consolidation therapy. The overall CR rate, following the completion of treatment, was 71%. The 3-year overall survival (OS) rate of all patients was 53%. In the univariate analysis, age (<or=50 years vs. >50 years) was the only factor affecting the OS. The 3-year disease-free survival (DFS) rate of patients with CR was 68%. In the univariate analysis, age and bone marrow involvement were the factors affecting the DFS. Two patients died from the treatment-related toxicity of the induction therapy: one due to sepsis and the other due to congestive heart failure.
  
  
  CONCLUSIONS
  Although the CR rate was relatively high, the OS or DFS of patients with a poor prognosis NHL, who had received the intensified induction using the Vanderbilt regimen, were no different from those that had received the conventional chemotherapy, as reported by the International Prognostic Index Project. However, the OS or DFS in the young patient groups were encouraging. To test the hypothesized benefits of our approach in the young patient groups, a larger cohort of patients aged 50 years or less should be studied.
authors.forename: Yoong Ju
authors.initials: YJ
authors.lastname: Kweon
authors.forename: Seong Jun
authors.initials: SJ
authors.lastname: Choi
authors.forename: Baek Yeol
authors.initials: BY
authors.lastname: Ryoo
authors.forename: Yeon Hee
authors.initials: YH
authors.lastname: Park
authors.forename: Bong Seog
authors.initials: BS
authors.lastname: Kim
authors.forename: Dae Han
authors.initials: DH
authors.lastname: Kim
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Kim
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Yo Ahn
authors.initials: YA
authors.lastname: Suh
authors.forename: Hyun Bae
authors.initials: HB
authors.lastname: Son
authors.forename: Kui Sung
authors.initials: KS
authors.lastname: Choi
authors.forename: Seung Sook
authors.initials: SS
authors.lastname: Lee
authors.forename: Yoon Koo
authors.initials: YK
authors.lastname: Kang