TY - JOUR
T1 - Chlorambucil, vincristine and cytarabine (COA) treatment of low grade lymphomas
AU - Iaffaioli, R. V.
AU - Frasci, G.
AU - Palmieri, G.
AU - Tagliaferri, P.
AU - Montesarchio, V.
AU - Pagliarulo, C.
AU - Tortoriello, A.
AU - Facchini, G.
AU - Matano, E.
AU - Laurlv, R.
AU - Bianco, A. R.
PY - 1995
Y1 - 1995
N2 - Forty-five patients with stage III-IV low grade non-Hodgkin's lymphoma (NHL) were treated with a non-intensive polychemotherapy regimen including chlorambucil-vincristine and cytarabine (Ara-C), termed COA, for a total of 366 courses, beginning in June 1986. Grade 4 myelotoxicity occurred in only 4/45 patients. No treatment related death was observed. All patients were evaluable for response. Overall, 38 (84% objective responses, including 31 (69% complete responses (CR), were observed. At a median follow-up of 57 (21-84+ months, only 8 deaths occurred. Twenty-seven (60% patients are still disease-free. All disease-free patients were in their first CR. The seven-year estimated survival is 71% and the estimated 7-year progression-free survival (PFS) was 48% The estimated probability of complete responders to be disease-free at 6 years is 78% Pretreatment laboratory parameters (serum levels of thymidine kinase, LDH and TNF-alpha showed a good prognostic relevance at using univariate analysis. At multivariate analysis, only the pretreatment serum levels of TNF-alpha were significantly associated with a higher CR achievement probability (p = 0.02) and a longer PFS (p = 0.02). We established a risk model for clinical outcome based on these 3 parameters. Patients having all parameters within the normal range at diagnosis, showed a very good prognosis (100% 7-year PFS and survival), while patients with all parameters increased had a very poor prognosis (0% 7-year PFS and 22% 7-year survival). In conclusion, COA treatment appears to be a non-toxic and very effective treatment for low-grade non-Hodgkin's lymphomas. More intensive treatment is probably needed for patients showing multiple negative prognostic laboratory parameters at diagnosis.
AB - Forty-five patients with stage III-IV low grade non-Hodgkin's lymphoma (NHL) were treated with a non-intensive polychemotherapy regimen including chlorambucil-vincristine and cytarabine (Ara-C), termed COA, for a total of 366 courses, beginning in June 1986. Grade 4 myelotoxicity occurred in only 4/45 patients. No treatment related death was observed. All patients were evaluable for response. Overall, 38 (84% objective responses, including 31 (69% complete responses (CR), were observed. At a median follow-up of 57 (21-84+ months, only 8 deaths occurred. Twenty-seven (60% patients are still disease-free. All disease-free patients were in their first CR. The seven-year estimated survival is 71% and the estimated 7-year progression-free survival (PFS) was 48% The estimated probability of complete responders to be disease-free at 6 years is 78% Pretreatment laboratory parameters (serum levels of thymidine kinase, LDH and TNF-alpha showed a good prognostic relevance at using univariate analysis. At multivariate analysis, only the pretreatment serum levels of TNF-alpha were significantly associated with a higher CR achievement probability (p = 0.02) and a longer PFS (p = 0.02). We established a risk model for clinical outcome based on these 3 parameters. Patients having all parameters within the normal range at diagnosis, showed a very good prognosis (100% 7-year PFS and survival), while patients with all parameters increased had a very poor prognosis (0% 7-year PFS and 22% 7-year survival). In conclusion, COA treatment appears to be a non-toxic and very effective treatment for low-grade non-Hodgkin's lymphomas. More intensive treatment is probably needed for patients showing multiple negative prognostic laboratory parameters at diagnosis.
KW - COA chemotherapy
KW - Low grade lymphomas
KW - Multivariate analysis
KW - Serum thymidine-kinase
KW - TNF-alpha
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U2 - 10.3109/10428199509051715
DO - 10.3109/10428199509051715
M3 - Article
C2 - 7773152
AN - SCOPUS:0028920002
VL - 17
SP - 147
EP - 153
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
SN - 1042-8194
IS - 1-2
ER -