Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
Print ISSN : 0300-9173
A Comparative Study of CHOP Therapy and COP-BLAM Therapy for non-Hodgkin's Lymphoma in elderly Patients
Nozomi AraiAkihiro HaraHaruo KanekoMasanori UmedaTatsuo Shirai
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1991 Volume 28 Issue 5 Pages 672-677

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Abstract

Elderly patients (aged ≥65 years) with non-Hodgkin's lymphoma were treated either with CHOP or COP-BLAM therapy, and the effectiveness and reverse effects of COP-BLAM therapy were compared with those of CHOP therapy. Thirty-three patients (aged ≥65 years) with previously untreated non-Hodgkin's lymphoma were entered either on CHOP or COP-BLAM regimen between September, 1979 and February 1990. To CHOP therapy was performed in 15 patients (median age; 70 years). Eight of them had diffuse large cell type lymphoma (large), five had diffuse medium-sized cell type (medium) and two had diffuse mixed cell type (mixed). As to clinical stage, there were patients in stage II, 4 in stage III and 9 in stage IV in CHOP group. Of 18 patients (median age; 68 years), who were treated with COP-BLAM therapy, 8 had of large lymphoma and 10 medium lymphomas in histopathological classification. In terms of clinical stage, there were 5 patients in stage II, 4 in stage III and 9 in stage IV. CHOP therapy and COP-BLAM therapy were performed according to the method reported by McKelvey et al, and by Laurence et al., respectively, using the full doses of drugs without consideration the age. Complete remission (CR) was achieved in seven (46.7%) of 15 patients treated with CHOP therapy. In this group, five (38.5%) of 13 patients in advanced stages (stage III or IV) entered CR. Of 18 patients subjected to COP-BLAM therapy, 15 (83.3%) achieved CR. Among 13 patients in advanced stage treated with COP-BLAM therapy, CR was achieved in 11 (84.6%). No significant difference in CR rate was found concerning the presence or absence of a bulky mass (larger than 8cm in diameter), bone marrow infiltration or B symptoms, and serum LDH levels (cutoff point; 400U/L) at a risk rate of 5%. As to adverse effects, we observed leukopenia (<1, 000/μL) in 26.7% of patients treated with CHOP and in 22.2% of patients treated with COP-BLAM, and thrombocytopenia (<5×104/μL) in 20.0% and 11.1% respectively. Other various adverse effects including nausea, vomiting, alopecia and peripheral neuropathy were observed. In elderly patients with non-Hodgkin's lymphoma COP-BLAM therapy demonstrated a higher CR rate with similar extent of adverse effects compared with CHOP therapy.

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