PERSISTENT IMPROVED RESULTS AFTER ADDING VINCRISTINE AND BLEOMYCIN TOA CYCLOPHOSPHAMIDE HYDROXORUBICIN/VM-26/PREDNISONE COMBINATION (CHVMP) IN STAGE III-IV INTERMEDIATE-GRADE AND HIGH-GRADE NON-HODGKINS-LYMPHOMA/

CHOP has been and still is regarded by many as the 'standard' treatmen t of advanced non-Hodgkin's lymphoma. In 1980 the EORTC Lymphoma Coope rative Group started a study to evaluate the addition of vincristine a nd bleomycin to its standard four-drug combination chemotherapy, CHVmP (cyclophosphamide, hydroxorubicin, Vm-26, prednisone). Eligible patie nts were stage III or IV, intermediate- to high-grade non-Hodgkin's ly mphoma (Working Formulation E-I). One-hundred-eighty-nine patients wer e entered, of whom 140 were eligible and evaluable, A previous report showed an improved response rate and failure-free survival (FFS) and o verall survival for the combination CHVmP-VB. At ten years, the outcom e still favors the addition of vincristine and bleomycin, The FFS was 34% vs, 23% and the overall survival 34% vs. 22%, This difference was mainly due to a difference in CR rate (74% vs. 49%), Relapse-free surv ival for patients reaching a CR was the same in both arms. When the pa tients were grouped according to the International Prognostic Factor I ndex, no statistically significant difference could be observed in fav or of one treatment within either group. This trial clearly demonstrat es the benefit gained by the addition of vincristine and bleomycin to 'standard' chemotherapy for intermediate and high-grade non-Hodgkin's lymphoma.