CEOP-B alternated with VIMB in intermediate-grade and high-grade non-Hodgkin's lymphoma: A pilot study

M. De Lena, P. Ditonno, V. Lorusso, M. Brandi, A. Timurian, F. Marzullo, V. Ventrella, A. Pellecchia

Research output: Contribution to journalArticle

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Abstract

Purpose: To improve response and toxicity in treatment of non-Hodgkin's lymphomas (NHLs), a prospective single-arm trial was initiated using cyclophosphamide, epirubicin, vincristine, prednisone, and bleomycin (CEOP-B) alternated with etoposide (VP-16), ifosfamide, mitoxantrone, and bleomycin (VIMB). Patients and Methods: From December 1988 to April 1992, 60 consecutive previously untreated patients with intermediate- or high-grade NHL were admitted to the study and were assessable. Patient characteristics were as follows: 32% greater than 60 years of age, 63% with stage III to IV disease, 42% with a performance status (PS) of 2 or 3, 23% with high lactate dehydrogenase (LDH) levels, and 22% with two or more extranodal disease sites. Stage I and II patients received three cycles of CEOP-B/VIMB plus radiotherapy (RT) to involved fields; stage III and IV patients received four cycles of chemotherapy alone. Results: The complete remission (CR) rate was 77%; actuarial 48-month overall survival (OS) and time to treatment failure (TTF) rates were 70% and 59%, respectively. With univariate analysis, CR, OS, and TTF rates were significantly influenced by serum LDH levels (P = .0485, P = .0017, and P = .0064, respectively) and performance status (P = .0005, P <.00005, and P = .0001, respectively). The actuarial 48-month disease-free survival (DFS) rate was 83% and was negatively influenced only by high-grade histology (P <.004). Toxicity was mild. A lower epirubicin dose-intensity (DI) was found in patients older than 60 years of age, with a borderline P value. Patients were divided into four groups according to the International Prognostic Factor Project; low-risk and low-intermediate-risk groups had similar OS and TTF rates; when considered together, they showed superior, but not statistically significant, OS and TTF rates as compared with the high-intermediate-risk group, which in turn had significantly superior OS and TTF rates when compared with the high-risk group. Conclusion: CEOP-B/VIMB compares favorably with third-generation regimens and results in lower toxicity.

Original languageEnglish
Pages (from-to)953-960
Number of pages8
JournalJournal of Clinical Oncology
Volume13
Issue number4
Publication statusPublished - Apr 1995

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Mitoxantrone
Ifosfamide
Etoposide
Non-Hodgkin's Lymphoma
Treatment Failure
Bleomycin
Survival
Epirubicin
L-Lactate Dehydrogenase
Vincristine
Prednisone
indium-bleomycin
Cyclophosphamide
Disease-Free Survival
Histology
Radiotherapy
Survival Rate
Drug Therapy
Serum

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

De Lena, M., Ditonno, P., Lorusso, V., Brandi, M., Timurian, A., Marzullo, F., ... Pellecchia, A. (1995). CEOP-B alternated with VIMB in intermediate-grade and high-grade non-Hodgkin's lymphoma: A pilot study. Journal of Clinical Oncology, 13(4), 953-960.

CEOP-B alternated with VIMB in intermediate-grade and high-grade non-Hodgkin's lymphoma : A pilot study. / De Lena, M.; Ditonno, P.; Lorusso, V.; Brandi, M.; Timurian, A.; Marzullo, F.; Ventrella, V.; Pellecchia, A.

In: Journal of Clinical Oncology, Vol. 13, No. 4, 04.1995, p. 953-960.

Research output: Contribution to journalArticle

De Lena, M, Ditonno, P, Lorusso, V, Brandi, M, Timurian, A, Marzullo, F, Ventrella, V & Pellecchia, A 1995, 'CEOP-B alternated with VIMB in intermediate-grade and high-grade non-Hodgkin's lymphoma: A pilot study', Journal of Clinical Oncology, vol. 13, no. 4, pp. 953-960.
De Lena, M. ; Ditonno, P. ; Lorusso, V. ; Brandi, M. ; Timurian, A. ; Marzullo, F. ; Ventrella, V. ; Pellecchia, A. / CEOP-B alternated with VIMB in intermediate-grade and high-grade non-Hodgkin's lymphoma : A pilot study. In: Journal of Clinical Oncology. 1995 ; Vol. 13, No. 4. pp. 953-960.
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abstract = "Purpose: To improve response and toxicity in treatment of non-Hodgkin's lymphomas (NHLs), a prospective single-arm trial was initiated using cyclophosphamide, epirubicin, vincristine, prednisone, and bleomycin (CEOP-B) alternated with etoposide (VP-16), ifosfamide, mitoxantrone, and bleomycin (VIMB). Patients and Methods: From December 1988 to April 1992, 60 consecutive previously untreated patients with intermediate- or high-grade NHL were admitted to the study and were assessable. Patient characteristics were as follows: 32{\%} greater than 60 years of age, 63{\%} with stage III to IV disease, 42{\%} with a performance status (PS) of 2 or 3, 23{\%} with high lactate dehydrogenase (LDH) levels, and 22{\%} with two or more extranodal disease sites. Stage I and II patients received three cycles of CEOP-B/VIMB plus radiotherapy (RT) to involved fields; stage III and IV patients received four cycles of chemotherapy alone. Results: The complete remission (CR) rate was 77{\%}; actuarial 48-month overall survival (OS) and time to treatment failure (TTF) rates were 70{\%} and 59{\%}, respectively. With univariate analysis, CR, OS, and TTF rates were significantly influenced by serum LDH levels (P = .0485, P = .0017, and P = .0064, respectively) and performance status (P = .0005, P <.00005, and P = .0001, respectively). The actuarial 48-month disease-free survival (DFS) rate was 83{\%} and was negatively influenced only by high-grade histology (P <.004). Toxicity was mild. A lower epirubicin dose-intensity (DI) was found in patients older than 60 years of age, with a borderline P value. Patients were divided into four groups according to the International Prognostic Factor Project; low-risk and low-intermediate-risk groups had similar OS and TTF rates; when considered together, they showed superior, but not statistically significant, OS and TTF rates as compared with the high-intermediate-risk group, which in turn had significantly superior OS and TTF rates when compared with the high-risk group. Conclusion: CEOP-B/VIMB compares favorably with third-generation regimens and results in lower toxicity.",
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T1 - CEOP-B alternated with VIMB in intermediate-grade and high-grade non-Hodgkin's lymphoma

T2 - A pilot study

AU - De Lena, M.

AU - Ditonno, P.

AU - Lorusso, V.

AU - Brandi, M.

AU - Timurian, A.

AU - Marzullo, F.

AU - Ventrella, V.

AU - Pellecchia, A.

PY - 1995/4

Y1 - 1995/4

N2 - Purpose: To improve response and toxicity in treatment of non-Hodgkin's lymphomas (NHLs), a prospective single-arm trial was initiated using cyclophosphamide, epirubicin, vincristine, prednisone, and bleomycin (CEOP-B) alternated with etoposide (VP-16), ifosfamide, mitoxantrone, and bleomycin (VIMB). Patients and Methods: From December 1988 to April 1992, 60 consecutive previously untreated patients with intermediate- or high-grade NHL were admitted to the study and were assessable. Patient characteristics were as follows: 32% greater than 60 years of age, 63% with stage III to IV disease, 42% with a performance status (PS) of 2 or 3, 23% with high lactate dehydrogenase (LDH) levels, and 22% with two or more extranodal disease sites. Stage I and II patients received three cycles of CEOP-B/VIMB plus radiotherapy (RT) to involved fields; stage III and IV patients received four cycles of chemotherapy alone. Results: The complete remission (CR) rate was 77%; actuarial 48-month overall survival (OS) and time to treatment failure (TTF) rates were 70% and 59%, respectively. With univariate analysis, CR, OS, and TTF rates were significantly influenced by serum LDH levels (P = .0485, P = .0017, and P = .0064, respectively) and performance status (P = .0005, P <.00005, and P = .0001, respectively). The actuarial 48-month disease-free survival (DFS) rate was 83% and was negatively influenced only by high-grade histology (P <.004). Toxicity was mild. A lower epirubicin dose-intensity (DI) was found in patients older than 60 years of age, with a borderline P value. Patients were divided into four groups according to the International Prognostic Factor Project; low-risk and low-intermediate-risk groups had similar OS and TTF rates; when considered together, they showed superior, but not statistically significant, OS and TTF rates as compared with the high-intermediate-risk group, which in turn had significantly superior OS and TTF rates when compared with the high-risk group. Conclusion: CEOP-B/VIMB compares favorably with third-generation regimens and results in lower toxicity.

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