title: [Clinical Study of Non Hodgkin's Lymphoma Treated with Enhanced Chemotherapy Regimen and Increased Treatment Courses].
abstract: OBJECTIVE
  To study the non-Hodgkin's lymphoma treated with enhanced chemotherapy regimen and increase of treatment courses, including number of treatment courses, short-term efficacy, long-term survival and safety.
  
  
  METHODS
  All the 254 cases of NHL in our hospital from January 2004 to February 2014 received a variety of intensive enhanced chemotherapy regimen, such as CHOPE, MAED, MMED and TAED. The median number of treatment course was 14, including 8 in the 1st year, 4 in the 2nd and 2 in the 3rd.
  
  
  RESULTS
  (1) In 254 assessable patients, 182 patients (71.7%) achieved complete responses (CR), 30 patients (11.8%) achieved partial responses (PR), 22 patients (8.7%) achieved stable disease (SD), 20 patients (7.9%) achieved progressive disease (PD), 212 patients (83.5%) achieved response rate (RR). The median time of following-up was 56.5 months, the overall survivals (OS) of 1, 3 and 5 years were 90.1%, 74.5% and 61.1% respectively, the median survival time was 69 months, and the disease-free survivals (DFS) were 81.8%, 65.4% and 54.7% respectively, the median DFS was 65 months. (2) In therapeutic effects at early phase, the 3-year OS of patients who achieved CR, PR, SD and PD were 92.2%, 56.0%, 20.2% and 0% respectively; The 5-year OS of patients who achieved CR through ≤4 cycle treatments and the 5-year OS of patients who achieved CR through >4 cycles treatments were 83.1% and 6.8%, their DFS were 72.4% and 0% respectively. (3) The relapse rates of patients who received < 6, 6-8, 9-10, 11-13, 14, 15 and 20 cycle treatments were 82.5%, 78.9%, 71.9%, 65.8%, 41.8%, 30.4% and 16.7%. The response rate (RR) of patients who received 6-8 traditional chemotherapy cycle as CHOP or CHOP-like regimen were 50%-60% and relapse rate > 70%.
  
  
  CONCLUSIONS
  Compared with traditional chemotherapy regimens, the dose-escalated, intensive and modified chemotherapy regimen can significatly improve the therapeutic efficiency for patients with NHL, including CR, long-term survival rate, and a good tolerance for patients. The chemotherapy intensity has been confirmed to be an important factor that associated with therapeutic efficiency. On the conditions tolerated by patients, the number of treatment cycles for NHL patients can be increased at lest 14, with 8 in the first year, 4 in the second year and 2 in the third year. The increase of chemotherapy cycle can obviously reduce the relapse rate and improve the long-term prognosis of patients. It is worth to further explore.
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China. E-mail: maxr0910@163.com.
authors.forename: Xiao-Rong
authors.initials: XR
authors.lastname: Ma
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Wang-Gang
authors.initials: WG
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Yin-Xia
authors.initials: YX
authors.lastname: Chen
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Xing-Mei
authors.initials: XM
authors.lastname: Cao
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Ai-Li
authors.initials: AL
authors.lastname: He
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Jian-Li
authors.initials: JL
authors.lastname: Wang
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Wan-Hong
authors.initials: WH
authors.lastname: Zhao
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Lei
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Peng-Yu
authors.initials: PY
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Fang-Xia
authors.initials: FX
authors.lastname: Wang
authors.affiliation: Department of Hematology, Second Hospital of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China.
authors.forename: Liu-Fang
authors.initials: LF
authors.lastname: Gu
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D003520:Cyclophosphamide; D018572:Disease-Free Survival; D004317:Doxorubicin; D005047:Etoposide; D006801:Humans; D008228:Lymphoma, Non-Hodgkin; D011241:Prednisone; D011379:Prognosis; D012008:Recurrence; D012074:Remission Induction; D014750:Vincristine
chemical_list: D014750:Vincristine; D005047:Etoposide; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone