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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
2
|
| pubmed:dateCreated |
1991-8-16
|
| pubmed:abstractText |
A novel chemotherapeutic approach was designed for the treatment of intermediate and high-grade histology non-Hodgkin's lymphoma using augmented (but subtransplantation) doses of chemotherapy administered at frequent intervals in the inpatient setting. For the initial evaluation of this regimen, poor prognosis patients were treated with a projected long-term survival rate of less than 25% in response to standard therapy. Between March 1982 and May 1988, 56 previously untreated patients were entered into this study; all patients had either high-grade histology (20 patients) or predominantly large cell lymphoma (36 patients). Median age was 41.5 years (range, 18 to 69 years). Poor prognosis features included: Stage IV, 71%; poor performance status (Eastern Cooperative Oncology Group scale, 2 to 4), 55%; multiple extranodal sites of disease, 52%; elevated lactic dehydrogenase (greater than 300 IU/l), 43%; and bulky (greater than 10 cm) tumor masses, 30%. Thirty-three of 56 patients (59%) were in Shipp's Category 3. During the 6-year study, the chemotherapy regimen was modified in an attempt to improve efficacy and reduce toxicity. However, most patients received a 2-month course of therapy as follows: cyclophosphamide 1500 mg/m2 intravenously (IV) on days 1, 2, and 29; etoposide 400 mg/m2 IV on days 1, 2, and 3 and 100 mg/m2 on days 29, 30, 31; doxorubicin 45 mg/m2 IV on days 29, 30; vincristine 1.4 mg/m2 IV on days 8, 22, 36, and 50; bleomycin 10 units/m2 IV on days 8, 22, 36, and 50; methotrexate 200 mg/m2 IV on days 15 and 43 followed 24 hours later by leucovorin 15 mg/m2 IV every 6 hours for six doses; and prednisone 60 mg/m2 orally on days 1 to 7 and 29 to 35. The complete response (CR) rate was 77% (95% confidence interval, 64% to 86%). There were ten relapses, only one of which occurred after 18 months of follow-up. Overall event-free survival (EFS) was 52% (95% confidence interval, 36% to 68%), with a median follow-up of 36 months. Eleven of 13 patients with small noncleaved lymphoma had CR; actuarial EFS in this subgroup was 61%. Myelosuppression occurred in all patients, with severe leukopenia (less than 1000/microliters) lasting a median of 12 days (range, 3 to 29 days); toxic deaths occurred in five patients (9%; 95% confidence interval, 4% to 19%). This intensive approach improved the response and survival of very poor risk non-Hodgkin's lymphoma patients.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Bleomycin,
http://linkedlifedata.com/resource/pubmed/chemical/Cyclophosphamide,
http://linkedlifedata.com/resource/pubmed/chemical/Cytarabine,
http://linkedlifedata.com/resource/pubmed/chemical/Doxorubicin,
http://linkedlifedata.com/resource/pubmed/chemical/Etoposide,
http://linkedlifedata.com/resource/pubmed/chemical/L-Lactate Dehydrogenase,
http://linkedlifedata.com/resource/pubmed/chemical/Leucovorin,
http://linkedlifedata.com/resource/pubmed/chemical/Methotrexate,
http://linkedlifedata.com/resource/pubmed/chemical/Prednisone,
http://linkedlifedata.com/resource/pubmed/chemical/Vincristine
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jul
|
| pubmed:issn |
0008-543X
|
| pubmed:author | |
| pubmed:issnType |
Print
|
| pubmed:day |
15
|
| pubmed:volume |
68
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
233-41
|
| pubmed:dateRevised |
2007-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:1712662-Adult,
pubmed-meshheading:1712662-Aged,
pubmed-meshheading:1712662-Antineoplastic Combined Chemotherapy Protocols,
pubmed-meshheading:1712662-Bleomycin,
pubmed-meshheading:1712662-Cyclophosphamide,
pubmed-meshheading:1712662-Cytarabine,
pubmed-meshheading:1712662-Doxorubicin,
pubmed-meshheading:1712662-Etoposide,
pubmed-meshheading:1712662-Female,
pubmed-meshheading:1712662-Follow-Up Studies,
pubmed-meshheading:1712662-Humans,
pubmed-meshheading:1712662-L-Lactate Dehydrogenase,
pubmed-meshheading:1712662-Leucovorin,
pubmed-meshheading:1712662-Lymphatic Metastasis,
pubmed-meshheading:1712662-Lymphoma, Non-Hodgkin,
pubmed-meshheading:1712662-Male,
pubmed-meshheading:1712662-Methotrexate,
pubmed-meshheading:1712662-Middle Aged,
pubmed-meshheading:1712662-Neoplasm Staging,
pubmed-meshheading:1712662-Prednisone,
pubmed-meshheading:1712662-Prognosis,
pubmed-meshheading:1712662-Remission Induction,
pubmed-meshheading:1712662-Retrospective Studies,
pubmed-meshheading:1712662-Survival Rate,
pubmed-meshheading:1712662-Vincristine
|
| pubmed:year |
1991
|
| pubmed:articleTitle |
Results of treatment with high intensity, brief duration chemotherapy in poor prognosis non-Hodgkin's lymphoma.
|
| pubmed:affiliation |
Division of Oncology, Vanderbilt University School of Medicine, Nashville, Tennessee.
|
| pubmed:publicationType |
Journal Article
|