A prospective randomized study of CHOP versus CHOP plus alpha-2B interferon in patients with intermediate and high grade non-Hodgkin's lymphoma: The International Oncology Study Group NHL1 study

The addition of a brief alpha interferon regimen to each CHOP induction cyc le, plus one year of alpha interferon thrice weekly maintenance therapy, ha s no early effect on response rates or survival in patients with Intermedia te or High grade cell NHL. Background: The CHOP (Cyclophosphamide, Adriamycin, Vincristine, Prednisone ) regimen is the most widely used first-line therapy for patients with Inte rmediate or High Grade (IG/HG) non-Hodgkin's lymphoma (NHL). Alpha 2b inter feron (INF) enhances response rates and improves survival in low-grade NHL. The International Oncology Study Group (IOSG) conducted a prospective rand omized study comparing CHOP alone or combined with INF in patients with IG/ HG-NHL. The primary study aim was to compare the objectiveresponse rates in these patient cohorts. Patients and Methods: Patients with a confirmed dia gnosis of measurable NHL of International Working Formulation (IWF) groups D to H histology were randomized to receive CHOP alone or CHOP with 5Mu INF SC for 5 days on days 22 to 26 of each 28 day cycle with INF 5 million uni ts (Mu) given three times per week subcutaneously for 52 weeks in those pat ients who responded to CHOP plus INF Results: The overall response rates we re equivalent in both groups: CHOP alone (214 patients) 81% (complete 55%, partial 26%): CHOP plus INF (221 patients) 80% (complete 54%, partial 26%). At 36 months, the actuarial survival rate was equivalent in both groups. C onclusions: There is no apparent early advantage in terms of response or su rvival conferred by adding the study INF regimen to CHOP therapy for patien ts with IG/HC-NHL.