CHOP VS PROMACE-CYTABOM IN THE TREATMENT OF AGGRESSIVE NON-HODGKINS-LYMPHOMAS - LONG-TERM RESULTS OF A MULTICENTER RANDOMIZED TRIAL

From May 1985 to May 1989, 175 patients with previously untreated aggr essive non-Hodgkin's lymphoma were randomized to receive CHOP or ProMA CE-CytaBOM. Eligibility criteria included follicular large-cell, diffu se small cleaved-cell, diffuse mixed, diffuse large-cell and immunobla stic lymphoma with an Ann Arbor stage II, III or IV. One hundred and f orty-eight patients were evaluable. There were no significant differen ces between the 2 treatments in response rate (83.5% [57.5% CR] for CH OP vs. 88% [62% CR] for ProMACE-CytaBOM), time to treatment failure (2 9% vs. 31% at 5 yr), or overall survival (42% in both groups at 5 yr). Furthermore, there were no significant differences between the 2 regi mens when response rates and outcome were analyzed for different progn ostic subgroups. Toxicity was not significantly different between the 2 regimens, although only 1 patient died as result of treatment relate d toxicity in the CHOP arm compared to 6 patients in the ProMACE-CytaB OM group (p = 0.126). In conclusion, in this study ProMACE-CytaBOM has not proved to be superior to CHOP in aggressive lymphomas. This trial gives support to the notion that CHOP still is the standard chemother apy for aggressive lymphomas, and that new treatment approaches for th ese lymphomas should be compared to CHOP.