The role of maintenance therapy in the treatment of large-cell non-Hodgkin's lymphoma.

Eighty-one patients with large-cell non-Hodgkin's lymphoma achieving complete restaging verified remission after induction chemotherapy (CHOP-Bleo or m-BACOD) were randomized to the following 3 arms: 1. No further treatment (observation). 2. Early consolidation therapy with 6 courses of CVP (cyclophosphamide, vincristine, prednisone) given monthly. 3. Maintenance therapy with cyclophosphamide and prednisone given every 6 weeks for 2 years. The relapse-free survival was better in the maintenance and consolidation arms than in the observation arm. The additional therapy given after the initial complete remission produced lasting disease control in a considerable number of patients and with acceptable toxicity. The authors feel that patients with large-cell lymphoma do not need more aggressive and toxic initial management because the use of maintenance therapy can increase the number of patients remaining in complete remission by more conventional, less toxic chemotherapy.