Adding interferon alfa to induction chemotherapy improves disease-free survival in non-Hodgkin's lymphoma

Abstract The evaluation of the results of CVP and MOPP chemotherapy in 80 patients with advanced stages of non-Hodgkin’s lymphoma indicates that 36 (45%) achieved a complete remission. Twenty-eight per cent of the entire group of patients remain free of disease for periods ranging from 4 mo to over 7 yr, with a projected median duration of complete remission of 3½ yr. Significant differences in prognosis relative to histologic categories were found. Well-differentiated and nodular histology were positive determinants for improved median survival, confirming the over-all clinical validity of the Rappaport classification system for the non-Hodgkin’s lymphomas. The median survival for patients in the most clinically aggressive subgroups with diffuse histology is inferior to those with nodular patterns or well-differentiated cells. In this study it was demonstrated that it was possible to achieve a significant number of complete remissions even in the most aggressive histologic subgroups using combination chemotherapy, and these responses can be correlated with an extended disease-free survival without further therapy.

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Interferon Alfa Consolidation After Intensive Chemotherapy Does Not Prolong the Progression-Free Survival of Patients With Low-Grade Non-Hodgkin’s Lymphoma: Results of the Southwest Oncology Group Randomized Phase III Study 8809

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.10.2010 ◽

2000 ◽

Vol 18 (10) ◽

pp. 2010-2016 ◽

Cited By ~ 65

Author(s):

Richard I. Fisher ◽

Bruce W. Dana ◽

Michael LeBlanc ◽

Carl Kjeldsberg ◽

Jeffrey D. Forman ◽

...

Keyword(s):

Hodgkin’S Lymphoma ◽

Progression Free Survival ◽

Interferon Alfa ◽

Hodgkin's Lymphoma ◽

Phase Iii ◽

Low Grade ◽

Consolidation Therapy ◽

Free Survival ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

PURPOSE: S8809 is a randomized phase III trial determining whether intensive cytoreductive treatment, followed by interferon consolidation at the time of minimal residual disease, prolongs the progression-free survival (PFS) or overall survival (OS) of indolent lymphoma patients. PATIENTS AND METHODS: Five hundred seventy-one patients with previously untreated stage III or IV low-grade non-Hodgkin’s lymphoma were registered. Patients received six to eight cycles of prednisone, methotrexate, doxorubicin, cyclophosphamide, and etoposide/mechlorethamine, vincristine, procarbazine, and prednisone (ProMACE[day 1]-MOPP[day 8]) chemotherapy or chemotherapy plus radiotherapy. Responding patients were randomized to observation alone or to interferon consolidation. Interferon alfa-2b 2 mU/m2 was given subcutaneously three times weekly for 2 years. RESULTS: Two hundred sixty-eight eligible patients were randomized to interferon alfa consolidation (n = 144) or observation alone (n = 124). With a median follow-up time from randomization among patients still alive of 6.2 years, the median PFS time was 4.1 years for patients who received interferon consolidation therapy and 3.2 years for patients who were observed after ProMACE-MOPP induction (P = .25). The adjusted hazard ratio for relapse for observation to interferon was 0.83 (95% confidence interval [CI], 0.61 to 1.13). The median OS has not been reached in either group. At 5 years, OS is 78% for the interferon group and 77% for the observation group (P = .65). The adjusted hazard ratio for survival for observation to interferon is 1.11 (95% CI, 0.69 to 1.79). CONCLUSION: Interferon alfa consolidation therapy after intensive treatment with anthracycline-containing combination chemotherapy and involved-field radiation therapy does not prolong the PFS or OS of patients with low-grade non-Hodgkin’s lymphoma.

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Chemotherapeutic results and prognostic factors of patients with advanced non-Hodgkin's lymphoma treated with VEPA or VEPA-M.

Journal of Clinical Oncology ◽

10.1200/jco.1988.6.1.128 ◽

1988 ◽

Vol 6 (1) ◽

pp. 128-141 ◽

Cited By ~ 96

Author(s):

M Shimoyama ◽

K Ota ◽

M Kikuchi ◽

K Yunoki ◽

S Konda ◽

...

Keyword(s):

Prognostic Factors ◽

Survival Rate ◽

T Cell ◽

Hodgkin’S Lymphoma ◽

Survival Rates ◽

Disease Free Survival ◽

Hodgkin's Lymphoma ◽

Free Survival ◽

Non Hodgkin's Lymphoma ◽

Disease Free

One hundred sixty-three patients with advanced non-Hodgkin's lymphoma including adult T cell leukemia/lymphoma (ATL) were treated from 1981 to 1983 with VEPA (vincristine, cyclophosphamide, prednisolone, and doxorubicin) or VEPA-M (VEPA plus methotrexate) in randomized fashion after stratification by surface marker. The complete response (CR) rate and the 4-year survival rate of patients treated with VEPA-M was 62.2% and 36.9%, respectively, while for those treated with VEPA the rates were 51.9% and 26.6, respectively. The difference was not statistically significant, but pretreatment characteristics predictive for response and survival were interesting. Three factors, leukemic change, poor performance status (PS), and T cell marker, were negatively associated with both CR and survival rates, and high-grade pathology was adversely associated with survival rate in a multivariate analysis. These prognostic factors are somewhat different from those in Western lymphomas. This may be reflection of major differences in patients' characteristics between Japanese and Western lymphomas: in this study, there was a high incidence of T cell lymphoma/leukemia (50%) including ATL (33%), leukemic manifestation (34%), poor PS (34%), and a low incidence of follicular lymphoma (9%). The statistically significant three factors for both CR and survival rates were used to construct a model containing eight categories of patients at increasing risk for poor response and shortened survival. These categories were divided into four groups, with respective CR and 4-year survival rates of 91% and 73%, 67% and 35%, 27% and 7%, and 10% and 5%. Ninety-three patients in whom CR was induced by VEPA or VEPA-M therapy were evaluated for prognostic factors predictive for disease-free survival. A shorter period (less than 28 days) required to achieve CR, a clinical diagnosis of ATL, and a lower hemoglobin level were found to affect disease-free survival adversely. These results have important implications for both the design of prospective randomized therapeutic trials and the determination of optimal therapy for individual patients.

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18FDG-PET following treatment as valid predictor for disease-free survival in Hodgkin’s lymphoma

Annals of Oncology ◽

10.1023/a:1008357126404 ◽

2001 ◽

Vol 12 (1) ◽

pp. 29-37 ◽

Cited By ~ 121

Author(s):

M. de Wit ◽

K.H. Bohuslavizki ◽

R. Buchert ◽

D. Bumann ◽

M. Clausen ◽

...

Keyword(s):

Hodgkin’S Lymphoma ◽

Disease Free Survival ◽

Hodgkin's Lymphoma ◽

Free Survival ◽

18Fdg Pet ◽

Valid Predictor ◽

Disease Free

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Relationship between response rates and median progression-free survival in non-Hodgkin's lymphoma: A meta-analysis of published clinical trials

Hematological Oncology ◽

10.1002/hon.2463 ◽

2017 ◽

Vol 36 (1) ◽

pp. 37-43 ◽

Cited By ~ 6

Author(s):

Naveen Mangal ◽

Ahmed Hamed Salem ◽

Mengyao Li ◽

Rajeev Menon ◽

Kevin J. Freise

Keyword(s):

Clinical Trials ◽

Hodgkin’S Lymphoma ◽

Meta Analysis ◽

Progression Free Survival ◽

Response Rates ◽

Hodgkin's Lymphoma ◽

Free Survival ◽

Median Progression Free Survival ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

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High-dose carmustine, etoposide, and cisplatin and autologous bone marrow transplantation for relapsed and refractory lymphoma.

Journal of Clinical Oncology ◽

10.1200/jco.1992.10.11.1682 ◽

1992 ◽

Vol 10 (11) ◽

pp. 1682-1689 ◽

Cited By ~ 54

Author(s):

H M Lazarus ◽

P Crilley ◽

N Ciobanu ◽

R J Creger ◽

R M Fox ◽

...

Keyword(s):

Hodgkin's Disease ◽

Hodgkin’S Lymphoma ◽

Hodgkin’S Disease ◽

Autologous Bone Marrow Transplantation ◽

Autologous Bone Marrow ◽

Hodgkin's Lymphoma ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma ◽

Autologous Bone ◽

Disease Free

PURPOSE We determined the toxicity and efficacy of a new preparative autologous bone marrow transplantation (ABMT) regimen in patients with relapsed or refractory non-Hodgkin's lymphoma or Hodgkin's disease. PATIENTS AND METHODS Forty-four non-Hodgkin's lymphoma and 35 Hodgkin's disease patients 16 to 63 years of age were given intravenous carmustine (BCNU) 600 to 1,050 mg/m2, etoposide 2,400 to 3,000 mg/m2, and cisplatin 200 mg/m2 (BEP) and ABMT. Fifty-nine patients also received 15 to 20 Gy local radiation (involved-field radiotherapy [RI]) to active or previously bulky (> 5 cm) disease sites. RESULTS Nonhematologic toxicities included nausea, vomiting, high-tone hearing loss, stomatitis, esophagitis, diarrhea, and hepatic and pulmonary toxicity. Two patients died within 40 days of marrow infusion as a result of sepsis and one patient died 7 months after transplant as a result of pulmonary fibrosis. Complete remissions (CRs) were noted in 72% (n = 57) of patients (n = 33 non-Hodgkin's lymphoma; n = 24 Hodgkin's disease). Forty patients (51%) remained alive and disease-free (n = 24 non-Hodgkin's lymphoma; n = 16 Hodgkin's disease) at a median of 17 (range, 8 to 57) months after marrow reinfusion. CONCLUSIONS This regimen seems to be effective for relapsed lymphoma patients whose disease continues to exhibit chemotherapy sensitivity (16 of 24 [67%] disease-free). Furthermore, this regimen seems to be effective in patients who have never attained a CR (seven of 19 [37%] disease-free).

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Autologous versus allogeneic bone marrow transplantation for non-Hodgkin's lymphoma: a case-controlled analysis of the European Bone Marrow Transplant Group Registry data.

Journal of Clinical Oncology ◽

10.1200/jco.1992.10.11.1690 ◽

1992 ◽

Vol 10 (11) ◽

pp. 1690-1695 ◽

Cited By ~ 138

Author(s):

R Chopra ◽

A H Goldstone ◽

R Pearce ◽

T Philip ◽

F Petersen ◽

...

Keyword(s):

Bone Marrow ◽

Hodgkin’S Lymphoma ◽

Progression Free Survival ◽

Lymphoblastic Lymphoma ◽

Hodgkin's Lymphoma ◽

Controlled Study ◽

Progression Rate ◽

Free Survival ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

PURPOSE A case-controlled study of patients who reported to the European Bone Marrow Transplant Group (EBMTG) was performed to investigate the relative roles and efficacy of allogeneic (alloBMT) and autologous bone marrow transplantation (ABMT) in non-Hodgkin's lymphoma. PATIENTS AND METHODS Of 1,060 patients who reported to the lymphoma registry, 938 patients underwent ABMT and 122 patients underwent alloBMT. A case-controlled study was performed by matching 101 alloBMT patients with 101 ABMT patients. The case matching was performed after the selection of the main prognostic factors for progression-free survival by a multivariate analysis. RESULTS The progression-free survival was similar in both types of transplants (49% alloBMT v 46% ABMT). The overall relapse and progression rate for the alloBMT patients was 23% compared with 38% in the ABMT patients. This difference was not significant statistically. In the lymphoblastic lymphoma subgroup, alloBMT was associated with a lower relapse rate than ABMT (24% alloBMT v 48% ABMT; P = .035). The progression-free survival, however, was not significantly different because patients with lymphoblastic lymphoma who underwent alloBMT had a higher procedure-related mortality (24% alloBMT v 10% ABMT; P = .06). A significantly lower relapse/progression rate was also observed in patients with chronic graft-versus-host disease (cGVHD) compared with those patients without (0% cGVHD v 35% no cGVHD; P = .02). Fourteen of 18 patients who had cGVHD also had lymphoblastic lymphoma. CONCLUSION This study suggests that ABMT and alloBMT for non-Hodgkin's lymphoma are comparable, with the exception of lymphoblastic lymphoma in which a graft-versus-lymphoma effect may account for the lower relapse rate for patients who underwent alloBMT.

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