Comparison of CHOP versus CIOP in good prognosis younger patients with histologically aggressive non-Hodgkin lymphoma.
BRITISH JOURNAL OF HAEMATOLOGY(2005)
摘要
CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) has been the standard chemotherapy regimen used for diffuse large cell lymphomas for over 30 years. Idarubicin is a 4-demethoxy-anthracycline analogue of daunorubicin that has proven activity in non-Hodgkin lymphoma, and has been reported to cause less cardiotoxicity. We therefore initiated a randomised trial of standard dose CHOP versus CIOP (cyclophosphamide, idarubicin, vincristine and prednisolone), in which doxorubicin 50 mg/m(2) was substituted by idarubicin 10 mg/m(2), a dose thought to have equivalent anti-lymphoma activity. This trial was closed prematurely after 211 patients had completed therapy when a lower complete remission (CR) rate was noted in the CIOP arm. The formal results with long-term follow up are now reported. Overall response rate was 84% in the CHOP arm and 78% in the CIOP arm, CR rates were 70% and 52% respectively in all patients (P = 0.013) and 73% and 52% respectively for the eligible patients (P = 0.0084). At a median of 8 years follow-up, 4-year progression-free survival for all patients was 56% in the CHOP arm and 40% in the CIOP arm (P = 0.0096). Overall survival for all patients was 65% in the CHOP arm and 56% in the CIOP arm (P = 0.14). Results for eligible patients were comparable. CIOP containing idarubicin at a dose of 10 mg/m(2) is clearly inferior to standard CHOP.
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关键词
non-Hodgkin lymphoma,histologically aggressive,CHOP,CIOP,idarubicin
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