ETOPOSIDE AND IDARUBICIN IN A MODIFIED CHOP-LIKE REGIMEN (VICED) FOR AGGRESSIVE NON-HODGKINS-LYMPHOMAS

The superiority of intensive versus standard chemotherapy for aggressi ve (I: intermediate; H: high grade) NHL is still debated; increased an titumor activity may be counterbalanced by increased toxicity. We have designed a first-line five-drug regimen (vincristine, idarubicin, cyc lophosphamide, etoposide and deflazacort), with the aim of potentiatin g the CHOP protocol without losing tolerability and ease of administra tion. Seventy-one patients (33% aged greater than or equal to 65) ente red the study. CR was obtained in 66.7% of patients (I: 74%; H: 56%), PR in 19.7%: overall response rate was 86.4%. Six patients were resist ant, two died during treatment. With a median follow up of two years, relapse has occurred in 14 patients (8 I, 6 H). At 3 years, overall su rvival was projected to be 62.5% (I 73.5%; H 31.4%), disease free surv ival 66% (I 71%, H 56.3%). No organ toxicity occurred. Myelosuppressio n was moderate, with a nadir on the 14th day. Febrile episodes occurre d in 16% of courses, dose delay in 19% of courses; dose reduction in 3 % of patients. No patient required hospitalization. G-CSF was only occ asionally used. This regimen has shown a potent antitumor effect with an excellent tolerance, even in elderly patients.