WEEKLY VAPEC-B CHEMOTHERAPY FOR HIGH-GRADE NON-HODGKINS-LYMPHOMA - RESULTS OF TREATMENT IN 184 PATIENTS

Background and patients: A weekly schedule of chemotherapy (VAPEC-B) h as been used to treat 184 consecutive patients with high grade non-Hod gkin's lymphoma (NHL). Median age for the group was 57 years (range 17 -84) and 56% had stage IV disease. Results: Following chemotherapy, 11 4 (62%) patients achieved CR or CR(u), 32 (17%) PR and 15 (8%) had not responded or progressed. Response to VAPEC-B was highly stage depende nt with 70% or more of patients with stages I-III achieving CR or CR(u ) but only 50% of those with stage IV Twenty-four (15%) patients died during treatment with VAPEC-B and in 13 cases death was due to sepsis. This complication occurred mainly in patients with stage IV disease a ged 60 years or older. After a median follow up period of 4.1 years, t he actuarial 4 year survival for 184 patients is 45%, an overall resul t heavily influenced by the poor outcome for 103 patients with stage I V disease (4 year survival of 280/.). Patients with earlier stage dise ase fared correspondingly better (44% for stage III, 68% for stage II and 80% for stage I). Conclusions: VAPEC-B gives similar results to ot her chemotherapy regimens currently used in the treatment of high grad e NHL and has the advantage of brevity. Caution is advised in patients over the age of 60 especially in the presence of stage IV disease and dose reduction or haemopoietic growth factor support should be consid ered in these circumstances.