COPP CHEMOTHERAPY FOR ELDERLY PATIENTS WITH INTERMEDIATE AND HIGH-GRADE NON-HODGKINS-LYMPHOMA

One hundred and forty-one consecutive patients above and 231 below the age of 60 years with previously untreated intermediate or high grade non-Hodgkin's lymphoma were included in this study. Patients above the age of 60 years were treated with the COPP chemotherapy regimen. The younger patients, at or below the age of 60, received a doxorubicin-co ntaining regimen (119 had CHOP, 65 had BACOP and 47 had m-BACOD). For stage I patients, the clinical results were similar but for stage II, III or IV disease, those receiving COPP had significantly worse CR rat e and survival than those who had a doxorubicin-containing regimen. Mu ltivariate analysis on patients receiving the COPP chemotherapy reveal ed that the independent prognostic variables significantly determining CR rate and survival included clinical stage (p = 0.04) and serum lac tate dehydrogenase level (p = 0.001). Myelosuppression was the major t oxicity following COPP chemotherapy in this group of patients. There w ere 10 (7 per cent) treatment-related deaths. Compared to the reported results using doxorubicin-containing regimens to treat elderly patien ts with aggressive NHL in the literature, the more aggressive treatmen t does not appear to improve significantly the clinical outcome of thi s group of patients and seems to produce treatment results very much s imilar to COPP. However, accurate comparison is difficult because of t he variation in the patient characteristics. Further prospective contr olled randomized trials will be necessary to determine the optimal the rapy for these patients.