Chemotherapy with MECOP-B for Intermediate-Grade and High-Grade Non-Hodgkin’s Lymphoma in Saudi Arabia: Clinical Results and Analysis of Prognostic Factors

PURPOSE We examined a consecutive series of 78 patients with non-Hodgkin's lymphoma treated on prospective protocols with high-dose cyclophosphamide, carmustine (BCNU), and etoposide (CBV) plus autotransplantation to determine prognostic factors for time to treatment failure. PATIENTS AND METHODS Patients with relapsed, refractory, or poor-risk intermediate- and high-grade non-Hodgkin's lymphoma were treated with CBV with autologous marrow or peripheral-blood progenitor cell support. Patient characteristics before transplantation were examined in univariate analyses by the log-rank test and simultaneously in a Cox proportional hazards regression analysis. A best-predictive model was determined from those variables significant (P < .10) in the univariate test. RESULTS In univariate analysis, intermediate-grade and immunoblastic lymphoma, responsiveness to pretransplant salvage chemotherapy, and transplantation after primary therapy (first complete response [CR] or partial response [PR]) were associated with prolonged time to treatment failure. In proportional hazards multiple regression analysis, intermediate-grade and immunoblastic histology, responsive disease, and autotransplantation in first CR or PR were positive prognostic factors, and these characteristics are the basis of the best-predictive model for prolonged time to failure. Actuarial 3-year failure-free survival of patients with stable or responding disease at autotransplant was 54%. CONCLUSION CBV is an effective conditioning regimen in intermediate-grade and immunoblastic non-Hodgkin's lymphoma. Patients with these histologies transplanted while responding to primary therapy, or those with stable disease or disease responding to salvage therapy at the time of autotransplant, are most likely to benefit. Patients with lymphoblastic lymphoma or diffuse undifferentiated lymphoma did poorly with CBV and should be offered alternative therapy.

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Original article: Chemotherapy with MACOP-B and VACOP-B for intermediate- and high-grade non-Hodgkin's lymphoma: Clinical results and analysis of prognostic factors

Annals of Oncology ◽

10.1093/oxfordjournals.annonc.a058295 ◽

1992 ◽

Vol 3 (8) ◽

pp. 645-649 ◽

Cited By ~ 8

Author(s):

G. Pichert ◽

J. Peters ◽

R.A. Stahel ◽

C. Dommann ◽

R. Joss ◽

...

Keyword(s):

Prognostic Factors ◽

Hodgkin’S Lymphoma ◽

Clinical Results ◽

Hodgkin's Lymphoma ◽

High Grade ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

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Reproductive Factors and Risk of Intermediate- or High-Grade B-Cell Non-Hodgkin’s Lymphoma in Women

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.5.1381 ◽

2001 ◽

Vol 19 (5) ◽

pp. 1381-1387 ◽

Cited By ~ 51

Author(s):

Rebecca A. Nelson ◽

Alexandra M. Levine ◽

Leslie Bernstein

Keyword(s):

B Cell ◽

Postmenopausal Women ◽

Lower Risk ◽

Hodgkin’S Lymphoma ◽

Reproductive Factors ◽

Hodgkin's Lymphoma ◽

High Grade ◽

Intermediate Grade ◽

Non Hodgkin’S Lymphoma ◽

Non Hodgkin's Lymphoma

PURPOSE: The incidence rates of non-Hodgkin’s lymphoma (NHL) unrelated to human immunodeficiency virus infection are lower for women than for men; yet, few factors have been identified that may account for this difference in risk. NHL is difficult to study epidemiologically because this disorder represents a group of malignancies that differ in terms of morphologic presentation, immunologic features, genetic characteristics, prognosis, and etiology. PATIENTS AND METHODS: We conducted a population-based case-control study in women to determine whether reproductive factors or hormonal exposures might be related to the risk of high- or intermediate-grade B-cell NHL. We interviewed 177 female residents of Los Angeles County who were diagnosed with high- or intermediate-grade B-cell NHL between 1989 and 1992; each case patient was individually matched on age and race to a control subject who lived in her neighborhood. RESULTS: Women who had used oral contraceptives had significantly lower risk of intermediate- or high-grade NHL (multivariate odds ratio [OR] = 0.47; 95% confidence interval [CI], 0.26 to 0.86) than women who had never used these compounds. Among parous women, those who had used lactation suppressants (which contain high levels of estrogen) had significantly lower risk of NHL (multivariate OR = 0.50; 95% CI, 0.29 to 0.85) than unexposed women. Postmenopausal women had a somewhat greater risk of NHL than premenopausal women, whereas those postmenopausal women who had used hormone replacement therapy (HRT) (primarily estrogen) had somewhat lower risk than those who had not used HRT. CONCLUSION: Exogenous estrogens seem to have a protective effect on the risk of high- and intermediate-grade B-cell NHL. Although the mechanisms for such protection are not known, alterations in immune reactivity, cytokine expression, or B-cell modulation may play a role.

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