title: High Dose Chemotherapy in the Treatment of Poor Prognosis Malignant Lymphoma.
abstract: The aim of the present study was to evaluate an intensive chemotherapy regimen in patients with poor prognosis malignant lymphoma. Sixty previously untreated patients with malignant lymphoma of high- or high-intermediate risk were treated with an intensive regimen. Patients received increasing doses of cyclophosphamide 1000 mg/m(2), and epirubicin 120 mg/m(2), in an CEOP-Bleo regimen with granulocyte-macrophage colony stimulating factor as hematological support. Moreover the high clinical risk patients had more adverse prognostic factors such as bulky disease, elevated levels of beta 2 microglobulin and multiple extranodal sites of involvement at diagnosis. Complete response was achieved in 49 out of 60 patients (81%) (95% confidence interval 63% to 89%). With a median follow-up of 43.6 months (ranged 31 to 61 months), only five patients have relapsed. Thus, at 5-years 72% of the patients remain in first complete response and 74% of the patients are alive free of disease.
  
  
  RESULTS
  severe granulocytopenia was observed in the 46% of the chemotherapy cycles; infection-related granulocytopenia was observed in 17%, but no fatality due therapy was observed. Granulocyte recovery was faster and delay on treatment was minimal (3.4 days). No thrombocytopenia, severe mucositis or cardiac abnormalities were observed. The CEOP-Bleo regimen with increasing doses of cyclophosphamide and epirubicin is an useful and well tolerated regimen for the treatment of poor prognosis malignant lymphoma.
authors.affiliation: a Department of Hematology , Oncology Hospital, National Medical Center , México , D.F. Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Avilés
authors.affiliation: a Department of Hematology , Oncology Hospital, National Medical Center , México , D.F. Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Talavera
authors.affiliation: a Department of Hematology , Oncology Hospital, National Medical Center , México , D.F. Mexico.
authors.forename: J C
authors.initials: JC
authors.lastname: Díaz-Maqueo
authors.affiliation: a Department of Hematology , Oncology Hospital, National Medical Center , México , D.F. Mexico.
authors.forename: S
authors.initials: S
authors.lastname: Cleto
authors.affiliation: a Department of Hematology , Oncology Hospital, National Medical Center , México , D.F. Mexico.
authors.forename: N R
authors.initials: NR
authors.lastname: Díaz
authors.affiliation: a Department of Hematology , Oncology Hospital, National Medical Center , México , D.F. Mexico.
authors.forename: E L
authors.initials: EL
authors.lastname: García
keywords: Cyclophosphamide; epirubicin; granulocyte—macrophage colony stimulating factor; hematopoietic growth factors; malignant lymphoma; non-Hodgkin's lymphoma