A COOPERATIVE STUDY ON PROMACE-CYTABOM IN AGGRESSIVE NON-HODGKINS-LYMPHOMAS

Chemotherapy using cyclophosphamide, doxorubicin, etoposide, cytarabin e, bleomycin, vincristine, methotrexate with leucovorin, and prednison e (ProMACE-CytaBOM) for patients with intermediate or high grade non-H odgkin lymphomas (G, H and K according to the Working Formulation), wa s tested by the Gruppo Cooperative Lombardo to confirm the activity of the regimen and to test the feasibility and safety of administering t hird-generation drug regimen in a cooperative group setting. Among 64 previously untreated patients, aged between 20 and 71 years, 7 had sta ge IB-IIB, 12 had stage IIIA-B, 45 (67%) had stage IVA-B. There were 4 4 complete remissions (CRs) (69%) and 14 partial remissions (22%); the difference between patients in stage I-II-III (84% complete remission s) and those in stage IV (62% complete remissions) was statistically s ignificant. The median length of follow up was 20 months (range 1-60 m onths), with 56% of patients alive at 60 months and 53% of CRs patient s free of disease at 60 months. Patients in stage I-II-III have the be st survival and disease free survival compared to stage IV, 87% versus 42% and 72% versus 32% respectively (both with high statistical signi ficance). Grade 3-4 (WHO) haematological toxicity was observed in 39% of patients, with 3 septic deaths. Two more patients died with chemoth erapy related toxicity (1 stroke and 1 acute renal insufficiency). Adm inistration of ProMACE-CytaBOM is a feasible and safe regimen although it presents moderate toxicity. ProMACE-CytaBOM may represent improved treatment for aggressive lymphomas, in terms of duration of response and survival, but a longer follow up is needed.