MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas

P. Mazza, P. L. Zinzani, M. Martelli, M. Fiacchini, M. Bocchia, S. Pileri, B. Falini, M. F. Martelli, S. Amadori, G. Papa, M. Cantonetti, G. Lucarelli, L. Moretti, F. Calabresi, E. Ruggeri, F. Gherlinzoni, M. Bendandi, C. Guglielmi, V. Burgio, F. DammaccoV. M. Lauta, A. M. Liberati, F. Mandelli, S. Tura

Research output: Contribution to journalArticle

Abstract

A prospective randomized study on aggressive non-Hodgkin's lymphomas was conducted by investigators at several Italian institutions with the intent of comparing two third-generation conceptually different regimens: the regimen containing methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B), a short-term continuous twelve-week therapy, and F-MACHOP (5-fluorouracil, methotrexate with leucovorin rescue, cytarabine, cyclophosphamide, doxorubicin, vincristine, and prednisone), a monthly intensive cyclic treatment combining prednisone with six active non-cross-resistant cytotoxic drugs. The goals of this study were the response rate, relapse-free survival, and incidence of hematologic and nonhematologic toxicities. Two hundred-eighty-six patients included between 15 and 60 years fulfilled the criteria for entry to the study; 140 patients were treated with MACOP-B and 146 with F-MACHOP. The minimum follow-up was 24 months. Clinical characteristics of all patients were similar and known prognostic factors were equally distributed between the two groups. Complete remission (CR) was achieved by 61% and 67% of the patients treated with MACOP-B and F-MACHOP, respectively; 4% and 6% were primarily resistant, 2% and 5% respectively, died of causes directly related to therapy. At 50 months, 74% of all CR patients were alive without disease and there were no significant differences in relapse-free survival between the two groups: 75% in the F-MACHOP group and 73% in the MACOP-B group at 50 months. There was a higher incidence of mucositis among patients treated with MACOP-B than among those given F-MACHOP (11% vs 3.5% Higher incidences of severe cytopenia (51% vs 21% and of fatal sepsis (5% vs 2% were recorded among patients treated with F-MACHOP than with MACOP-B. The third-generation regimens, F-MACHOP and MACOP-B, are as effective as other regimens. A prognostic analysis taking into account the principal covariates (age, symptoms, stage, serum lactate dehydrogenase, mediastinum involvement, bulky disease, histology, therapy, and dose intensity) was assessed for their impact on complete response rate incidence and on relapse rate from complete response by multivariate analysis. The linear logistic model showed that symptoms, advanced stage, mediastinum involvement, and bulky disease are prognostic factors that increase the risk of a lower rate of complete response. These data confirm the important role of a pretreatment selection for the poor-risk patients and, on the basis of these parameters, it will probably be possible to consider these patients for high-dose therapy with autologous bone marrow transplantation or autologous hematopoietic stem-cell support.

Original languageEnglish
Pages (from-to)457-463
Number of pages7
JournalLeukemia and Lymphoma
Volume16
Issue number5-6
DOIs
Publication statusPublished - 1995

Fingerprint

Non-Hodgkin's Lymphoma
Prednisone
Therapeutics
Leucovorin
Incidence
Mediastinum
Vincristine
Methotrexate
Recurrence
Doxorubicin
Cyclophosphamide
Mucositis
Survival
Autologous Transplantation
Cytarabine
Bleomycin
Hematopoietic Stem Cells
Bone Marrow Transplantation
L-Lactate Dehydrogenase
Fluorouracil

Keywords

  • Complete response
  • F-MACHOP
  • High grade non-Hodgkin's lymphoma
  • Kiel classification
  • MACOP-B

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Mazza, P., Zinzani, P. L., Martelli, M., Fiacchini, M., Bocchia, M., Pileri, S., ... Tura, S. (1995). MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas. Leukemia and Lymphoma, 16(5-6), 457-463. https://doi.org/10.3109/10428199509054434

MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas. / Mazza, P.; Zinzani, P. L.; Martelli, M.; Fiacchini, M.; Bocchia, M.; Pileri, S.; Falini, B.; Martelli, M. F.; Amadori, S.; Papa, G.; Cantonetti, M.; Lucarelli, G.; Moretti, L.; Calabresi, F.; Ruggeri, E.; Gherlinzoni, F.; Bendandi, M.; Guglielmi, C.; Burgio, V.; Dammacco, F.; Lauta, V. M.; Liberati, A. M.; Mandelli, F.; Tura, S.

In: Leukemia and Lymphoma, Vol. 16, No. 5-6, 1995, p. 457-463.

Research output: Contribution to journalArticle

Mazza, P, Zinzani, PL, Martelli, M, Fiacchini, M, Bocchia, M, Pileri, S, Falini, B, Martelli, MF, Amadori, S, Papa, G, Cantonetti, M, Lucarelli, G, Moretti, L, Calabresi, F, Ruggeri, E, Gherlinzoni, F, Bendandi, M, Guglielmi, C, Burgio, V, Dammacco, F, Lauta, VM, Liberati, AM, Mandelli, F & Tura, S 1995, 'MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas', Leukemia and Lymphoma, vol. 16, no. 5-6, pp. 457-463. https://doi.org/10.3109/10428199509054434
Mazza, P. ; Zinzani, P. L. ; Martelli, M. ; Fiacchini, M. ; Bocchia, M. ; Pileri, S. ; Falini, B. ; Martelli, M. F. ; Amadori, S. ; Papa, G. ; Cantonetti, M. ; Lucarelli, G. ; Moretti, L. ; Calabresi, F. ; Ruggeri, E. ; Gherlinzoni, F. ; Bendandi, M. ; Guglielmi, C. ; Burgio, V. ; Dammacco, F. ; Lauta, V. M. ; Liberati, A. M. ; Mandelli, F. ; Tura, S. / MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas. In: Leukemia and Lymphoma. 1995 ; Vol. 16, No. 5-6. pp. 457-463.
@article{c69856c98c5a42f2a2f257a3af91f56e,
title = "MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas",
abstract = "A prospective randomized study on aggressive non-Hodgkin's lymphomas was conducted by investigators at several Italian institutions with the intent of comparing two third-generation conceptually different regimens: the regimen containing methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B), a short-term continuous twelve-week therapy, and F-MACHOP (5-fluorouracil, methotrexate with leucovorin rescue, cytarabine, cyclophosphamide, doxorubicin, vincristine, and prednisone), a monthly intensive cyclic treatment combining prednisone with six active non-cross-resistant cytotoxic drugs. The goals of this study were the response rate, relapse-free survival, and incidence of hematologic and nonhematologic toxicities. Two hundred-eighty-six patients included between 15 and 60 years fulfilled the criteria for entry to the study; 140 patients were treated with MACOP-B and 146 with F-MACHOP. The minimum follow-up was 24 months. Clinical characteristics of all patients were similar and known prognostic factors were equally distributed between the two groups. Complete remission (CR) was achieved by 61{\%} and 67{\%} of the patients treated with MACOP-B and F-MACHOP, respectively; 4{\%} and 6{\%} were primarily resistant, 2{\%} and 5{\%} respectively, died of causes directly related to therapy. At 50 months, 74{\%} of all CR patients were alive without disease and there were no significant differences in relapse-free survival between the two groups: 75{\%} in the F-MACHOP group and 73{\%} in the MACOP-B group at 50 months. There was a higher incidence of mucositis among patients treated with MACOP-B than among those given F-MACHOP (11{\%} vs 3.5{\%} Higher incidences of severe cytopenia (51{\%} vs 21{\%} and of fatal sepsis (5{\%} vs 2{\%} were recorded among patients treated with F-MACHOP than with MACOP-B. The third-generation regimens, F-MACHOP and MACOP-B, are as effective as other regimens. A prognostic analysis taking into account the principal covariates (age, symptoms, stage, serum lactate dehydrogenase, mediastinum involvement, bulky disease, histology, therapy, and dose intensity) was assessed for their impact on complete response rate incidence and on relapse rate from complete response by multivariate analysis. The linear logistic model showed that symptoms, advanced stage, mediastinum involvement, and bulky disease are prognostic factors that increase the risk of a lower rate of complete response. These data confirm the important role of a pretreatment selection for the poor-risk patients and, on the basis of these parameters, it will probably be possible to consider these patients for high-dose therapy with autologous bone marrow transplantation or autologous hematopoietic stem-cell support.",
keywords = "Complete response, F-MACHOP, High grade non-Hodgkin's lymphoma, Kiel classification, MACOP-B",
author = "P. Mazza and Zinzani, {P. L.} and M. Martelli and M. Fiacchini and M. Bocchia and S. Pileri and B. Falini and Martelli, {M. F.} and S. Amadori and G. Papa and M. Cantonetti and G. Lucarelli and L. Moretti and F. Calabresi and E. Ruggeri and F. Gherlinzoni and M. Bendandi and C. Guglielmi and V. Burgio and F. Dammacco and Lauta, {V. M.} and Liberati, {A. M.} and F. Mandelli and S. Tura",
year = "1995",
doi = "10.3109/10428199509054434",
language = "English",
volume = "16",
pages = "457--463",
journal = "Leukemia and Lymphoma",
issn = "1042-8194",
publisher = "Taylor and Francis Ltd.",
number = "5-6",

}

TY - JOUR

T1 - MACOP-b vs f-MACHOP regimen in the treatment of high-grade non-hodgkin's lymphomas

AU - Mazza, P.

AU - Zinzani, P. L.

AU - Martelli, M.

AU - Fiacchini, M.

AU - Bocchia, M.

AU - Pileri, S.

AU - Falini, B.

AU - Martelli, M. F.

AU - Amadori, S.

AU - Papa, G.

AU - Cantonetti, M.

AU - Lucarelli, G.

AU - Moretti, L.

AU - Calabresi, F.

AU - Ruggeri, E.

AU - Gherlinzoni, F.

AU - Bendandi, M.

AU - Guglielmi, C.

AU - Burgio, V.

AU - Dammacco, F.

AU - Lauta, V. M.

AU - Liberati, A. M.

AU - Mandelli, F.

AU - Tura, S.

PY - 1995

Y1 - 1995

N2 - A prospective randomized study on aggressive non-Hodgkin's lymphomas was conducted by investigators at several Italian institutions with the intent of comparing two third-generation conceptually different regimens: the regimen containing methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B), a short-term continuous twelve-week therapy, and F-MACHOP (5-fluorouracil, methotrexate with leucovorin rescue, cytarabine, cyclophosphamide, doxorubicin, vincristine, and prednisone), a monthly intensive cyclic treatment combining prednisone with six active non-cross-resistant cytotoxic drugs. The goals of this study were the response rate, relapse-free survival, and incidence of hematologic and nonhematologic toxicities. Two hundred-eighty-six patients included between 15 and 60 years fulfilled the criteria for entry to the study; 140 patients were treated with MACOP-B and 146 with F-MACHOP. The minimum follow-up was 24 months. Clinical characteristics of all patients were similar and known prognostic factors were equally distributed between the two groups. Complete remission (CR) was achieved by 61% and 67% of the patients treated with MACOP-B and F-MACHOP, respectively; 4% and 6% were primarily resistant, 2% and 5% respectively, died of causes directly related to therapy. At 50 months, 74% of all CR patients were alive without disease and there were no significant differences in relapse-free survival between the two groups: 75% in the F-MACHOP group and 73% in the MACOP-B group at 50 months. There was a higher incidence of mucositis among patients treated with MACOP-B than among those given F-MACHOP (11% vs 3.5% Higher incidences of severe cytopenia (51% vs 21% and of fatal sepsis (5% vs 2% were recorded among patients treated with F-MACHOP than with MACOP-B. The third-generation regimens, F-MACHOP and MACOP-B, are as effective as other regimens. A prognostic analysis taking into account the principal covariates (age, symptoms, stage, serum lactate dehydrogenase, mediastinum involvement, bulky disease, histology, therapy, and dose intensity) was assessed for their impact on complete response rate incidence and on relapse rate from complete response by multivariate analysis. The linear logistic model showed that symptoms, advanced stage, mediastinum involvement, and bulky disease are prognostic factors that increase the risk of a lower rate of complete response. These data confirm the important role of a pretreatment selection for the poor-risk patients and, on the basis of these parameters, it will probably be possible to consider these patients for high-dose therapy with autologous bone marrow transplantation or autologous hematopoietic stem-cell support.

AB - A prospective randomized study on aggressive non-Hodgkin's lymphomas was conducted by investigators at several Italian institutions with the intent of comparing two third-generation conceptually different regimens: the regimen containing methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B), a short-term continuous twelve-week therapy, and F-MACHOP (5-fluorouracil, methotrexate with leucovorin rescue, cytarabine, cyclophosphamide, doxorubicin, vincristine, and prednisone), a monthly intensive cyclic treatment combining prednisone with six active non-cross-resistant cytotoxic drugs. The goals of this study were the response rate, relapse-free survival, and incidence of hematologic and nonhematologic toxicities. Two hundred-eighty-six patients included between 15 and 60 years fulfilled the criteria for entry to the study; 140 patients were treated with MACOP-B and 146 with F-MACHOP. The minimum follow-up was 24 months. Clinical characteristics of all patients were similar and known prognostic factors were equally distributed between the two groups. Complete remission (CR) was achieved by 61% and 67% of the patients treated with MACOP-B and F-MACHOP, respectively; 4% and 6% were primarily resistant, 2% and 5% respectively, died of causes directly related to therapy. At 50 months, 74% of all CR patients were alive without disease and there were no significant differences in relapse-free survival between the two groups: 75% in the F-MACHOP group and 73% in the MACOP-B group at 50 months. There was a higher incidence of mucositis among patients treated with MACOP-B than among those given F-MACHOP (11% vs 3.5% Higher incidences of severe cytopenia (51% vs 21% and of fatal sepsis (5% vs 2% were recorded among patients treated with F-MACHOP than with MACOP-B. The third-generation regimens, F-MACHOP and MACOP-B, are as effective as other regimens. A prognostic analysis taking into account the principal covariates (age, symptoms, stage, serum lactate dehydrogenase, mediastinum involvement, bulky disease, histology, therapy, and dose intensity) was assessed for their impact on complete response rate incidence and on relapse rate from complete response by multivariate analysis. The linear logistic model showed that symptoms, advanced stage, mediastinum involvement, and bulky disease are prognostic factors that increase the risk of a lower rate of complete response. These data confirm the important role of a pretreatment selection for the poor-risk patients and, on the basis of these parameters, it will probably be possible to consider these patients for high-dose therapy with autologous bone marrow transplantation or autologous hematopoietic stem-cell support.

KW - Complete response

KW - F-MACHOP

KW - High grade non-Hodgkin's lymphoma

KW - Kiel classification

KW - MACOP-B

UR - http://www.scopus.com/inward/record.url?scp=0028952929&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0028952929&partnerID=8YFLogxK

U2 - 10.3109/10428199509054434

DO - 10.3109/10428199509054434

M3 - Article

C2 - 7540460

AN - SCOPUS:0028952929

VL - 16

SP - 457

EP - 463

JO - Leukemia and Lymphoma

JF - Leukemia and Lymphoma

SN - 1042-8194

IS - 5-6

ER -