THE F-MACHOP REGIMEN IN THE TREATMENT OF AGGRESSIVE NON-HODGKINS-LYMPHOMAS - A SINGLE-CENTER EXPERIENCE IN 72 PATIENTS

Background. Since July 1991 we have employed the F-MACHOP regimen for the treatment of aggressive non-Hodgkin's lymphomas (NHL). The aim of the present study was to evaluate the response rate and the toxicity o f this chemotherapy program. Patients and Methods. Seventy-two consecu tive patients entered the study and were treated with the F-MACHOP reg imen for 6 planned courses, given every 21 days. G- or GM-CSF were adm inistered whenever required. Results. Sixty-six patients (92%) obtaine d a response: 38 (53%) a complete remission (CR) and 28 (39%) a partia l remission (PR); 4 (6%) proved to be resistant and 2 (3%) died of che motherapy-related toxicity. Fifty-seven patients with a good performan ce status were subsequently selected to undergo autologous stem cell t ransplantation (ASCT). During chemotherapy, grade III-IV neutropenia w as observed in 59% of the patients; a significant drop in hemoglobin l evels was detected, with blood transfusions being required in 21% of t he cases; platelet counts were unaffected. The main extrahematological toxic events were: alopecia (100% of the patients), osteoarthromyalgi as (58%), grade I-II neuropathy (53%) and grade I-II hepatic toxicity (43%). Conclusions. Our study confirms the efficacy of the F-MACHOP re gimen in obtaining a high rate of response (CR+PR) in most aggressive NHL cases, with an acceptable toxicity and a low rate of toxic deaths. This regimen enables the majority of patients to be selected for ASCT as consolidation therapy without significant toxicity.