ALTERNATING CHEMOTHERAPY OF CHOP-BLEO AND POEM-BLEO FOR DIFFUSE LARGE-CELL LYMPHOMA - A SINGLE-INSTITUTIONAL STUDY WITH A LONG-TERM FOLLOW-UP

Diffuse large-cell lymphoma (DLCL) is a neoplasm that is curable with chemotherapy in an appreciable percentage of patients. However, not al l patients are cured and the best drug combination and optimal dose in tensity have not yet been established. In an attempt to improve comple te response rate and survival with minimal toxicity, we devised an alt ernating combination chemotherapy consisting of CHOP-Bleo (cyclo-phosp hamide, doxorubicin, vincristine, prednisolone, and bleomycin) and POE M-Bleo (prednisolone, vincristine, etoposide, mitoxantrone, and bleomy cin). Between March 1986 and October 1990, 30 newly-diagnosed patients with advanced DLCL were treated with the regimen. Of these 30 patient s, 14 (47%) were 61 years of age or more, 15 (50%) had stage IV diseas e, 14 (47%) presented with constitutional symptoms, and 7 (23%) had T- cell lymphoma. After the completion of therapy, 23 (77%) achieved a co mplete response and 6 (20%) had a partial response. The actuarial rela pse-free survival at 5 years is 52% and the overall survival projected to 5 years is 47%. Toxicity was generally mild and well tolerated. Al though this alternating regimen had substantial activity as front-line chemotherapy for advanced DLCL, we conclude that the observed respons e rate and survival do not essentially differ from those achieved with conventional regimens and further clinical trials are thus not warran ted.