Treatment of Malignant Lymphoma in Jichi Medical School Hospital

3) Treatment of Advanced Bad-risk Lymphoma with the M-CHOP Regimen

Abstract

From January 1984 to December 1986, 23 previously untreated or minimally treated patients with advanced bad-risk lymphoma were treated with 2 or 4 cycles of the M-CHOP regimen (methotrexate 1,000 mg/m² on day 14, cyclophosphamide 600 mg/m² on days 1 and 8, doxorubicin 50 mg/m² on day 1, vincristine 1.4 mg/m² on days 1 and 8, and prednisolone 100 mg on days 1∼5: folinic acid was given 24 hours after methotrexate at 50 mg/m² every 6 hours for 6 doses intravenously).
Twelve patients (52%) achieved complete remission (CR) and 9 (39%) had partial remission. Complete remission rate was significantly higher in patients without prior therapy. The median duration of follow-up for the entire series was 23 monthes. Relapse from CR occurred in 5 out of 12 (42%), and 7 were remained in their first CR at the 28th months. Most cases of relapse occurred within one year. Relapse was observed more frequently in patients who entered CR with 2 cycles of M-CHOP than those with 4 cycles.
Overall survival was 59% at the 31st months. Survival was not correlated with age, histological subtype, stage and surface marker.
The major toxic effect was myelosuppression with severe leukopenia and fever. Alopecia was observed in almost all patients. Mucositis occurred in 20% of patients. No treatment-related deaths were observed. The M-CHOP regimen showed limited efficacy to patients with advanced bad-risk lymphoma.