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Leuk Lymphoma ; 50(9): 1475-81, 2009 Sep.
Article in English | MEDLINE | ID: mdl-19579074

ABSTRACT

Recently, management of limited stage diffuse large cell lymphoma (DLCL) is trending toward a low intensity chemotherapy approach. Since 1993 we have used a brief weekly (6 weeks) chemotherapy scheme (Doxorubicin, Cyclophosphamide, Bleomycin, Vincristine, and Prednisone = ACOP-B) followed by involved field radiotherapy in 207 consecutive patients with well defined localized DLCL without age limit (median 57 years, range 18-85). Treatment was completed as designed in 183 of 207 patients (88%). One hundred and ninety-nine patients (96%) achieved complete remission. At a median follow-up of 66 months 170 patients are alive (82%), 168 of them free of disease. Twenty-nine patients experienced relapse after achieving a complete remission. Kaplan-Meier, risk of relapse was 24% after 13 years. Thirty (14.5%) patients have died, 14 (6.8%) due to lymphoma progression, one due to regimen toxicity and 15 (7.2%) from other causes while remaining in complete remission. The probability of overall survival and event free survival at 13 years was 78% (95% CI 70-87%) and 63% (95% CI 50-75), respectively. Crude rate of secondary malignancy was 5.26 /1000 person-years. The ACOP-B regimen plus involved field radiotherapy is well tolerated both short and long term and is an effective chemotherapy scheme for very well defined limited stage aggressive non-Hodgkin lymphomas in all age categories.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Bleomycin/administration & dosage , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/radiotherapy , Adolescent , Adult , Aged , Aged, 80 and over , Cyclophosphamide/administration & dosage , Disease Progression , Doxorubicin/administration & dosage , Doxorubicin/analogs & derivatives , Drug Administration Schedule , Follow-Up Studies , Humans , Italy , Lymphoma, Non-Hodgkin/mortality , Lymphoma, Non-Hodgkin/pathology , Middle Aged , Neoplasm Invasiveness , Prednisone/administration & dosage , Radiotherapy, Conformal/methods , Survival Analysis , Time Factors , Treatment Outcome , Vincristine/administration & dosage , Young Adult
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