VB-CHEP CHEMOTHERAPY REGIMEN FOR AGGRESSIVE NON-HODGKINS-LYMPHOMAS

Despite intensive search for the optimal combination chemotherapy for aggressive non-Hodgkin's lymphoma (NHL), the CHOP (cyclophosphamide, a driamycin, vincristine and prednisolone) regimen is still the standard therapy. We investigated the clinical efficacy of a new combination r egimen consisting of vincristine, bleomycin- cyclophosphamide, adriamy cin, etoposide and prednisolone (VB-CHEP) in patients with aggressive NHL. A total of 29 patients with aggressive NHL was enrolled into the protocol. Eight patients were consolidated with cisplatin and cytarabi ne and 5 patients received radiotherapy for bulky disease. Objective r esponse was achieved in 82.8% of the patients. Complete remission (CR) and partial remission rates were 72.4%, and 10.3%, respectively. CR r ate was significantly lower in patients with advanced stage, extranoda l disease and bone marrow involvement. Median follow-up time is 34+ mo nths; 17 patients are disease-free while 12 died and only 2 patients w ith CR have relapsed so far. Median response duration is 29 + months a nd the median survival is 48+ months. The survival rate is 69% in the first year and 66% in the second year. A total of 152 cycles were eval uated for toxicity. Major hematological toxicity was myelosuppression and neutropenia, detected in 50.65%, was mostly grades 1-2. Neutropeni c fever occurred in only 11 cycles. The side effects of the consolidat ion therapy were also acceptable. We conclude that the VB-CHEP regimen with consolidation therapy for high-risk patients may be an effective treatment for advanced stage aggressive NHL.