Gerhartz H H, Thiel E, Hiller E, Nerl C, Kolb H J, Wilmanns W, Huhn D
Med. Klinik III, Klinikum Grosshadern, Munich University, F.R.G.
Hematol Oncol. 1988 Jan-Mar;6(1):13-9. doi: 10.1002/hon.2900060104.
Between 1979 and 1985 61 consecutive patients with non-Hodgkin's lymphomas of unfavourable histology (mostly diffuse large cell lymphomas subclassified according to Kiel nomenclature) were treated in our departments by either the CHOP- (n = 34) or the COPBLAM-regimen (n = 27). A retrospective analysis revealed that prognostic variables, excluding primary central nervous system (CNS)-involvement (n = 5), were equally distributed between both groups. Remission rates were significantly higher in the COPBLAM treated patients as compared with the CHOP treated group (85 per cent versus 38 per cent CR, P = 0.001) even when cases with primary CNS-disease were excluded. The survival curve did not reach a plateau in CHOP treated cases, whereas 85 per cent of the COPBLAM treated group reached a plateau by 15 months. The mean observation time, however, was shorter in the COPBLAM treated group (37 versus 30 months, respectively). It is concluded that the COPBLAM regimen is superior to the CHOP-protocol in inducing complete responses in aggressive non-Hodgkin's lymphomas. Longer follow-ups are needed to definitely show if this corresponds to an increased proportion of 'cures'.
1979年至1985年间,我们科室连续收治了61例组织学类型不佳的非霍奇金淋巴瘤患者(大多为根据基尔命名法分类的弥漫性大细胞淋巴瘤),采用CHOP方案(n = 34)或COPBLAM方案(n = 27)进行治疗。一项回顾性分析显示,除原发性中枢神经系统(CNS)受累(n = 5)外,预后变量在两组间分布均衡。即便排除原发性中枢神经系统疾病的病例,COPBLAM治疗组的缓解率仍显著高于CHOP治疗组(完全缓解率分别为85%和38%,P = 0.001)。CHOP治疗组的生存曲线未达到平台期,而COPBLAM治疗组85%的患者在15个月时达到平台期。然而,COPBLAM治疗组的平均观察时间较短(分别为37个月和30个月)。结论是,在诱导侵袭性非霍奇金淋巴瘤完全缓解方面,COPBLAM方案优于CHOP方案。需要更长时间的随访才能确切表明这是否对应着“治愈”比例的增加。