Bishop J F, Wiernik P H, Wesley M N, Kaplan R S, Diggs C H, Barcos M P, Sutherland J C
University of Maryland Cancer Center, University of Maryland Hospital, Baltimore.
Leukemia. 1987 Jun;1(6):508-13.
Ninety-three stage III and IV patients with non-Hodgkin's lymphoma were randomized to either high dose CVP (cyclophosphamide 1500 mg/m2 i.v. day 1, vincristine 1.4 mg/m2 day 1, and prednisone 40 mg/m2 orally days 1-10) or high dose CAVP (cyclophosphamide 1000 mg/m2 i.v. day 1, doxorubicin 45 mg/m2 i.v. day 1, vincristine and prednisone as above). Overall, the complete response (CR) rates were similar (CVP 51%, CAVP 51%). Patients with the International Working Formulation diffuse large cell lymphoma had significantly higher CR with CAVP. No difference in CR duration was detected between the two regimens. CRs were durable with 68% of diffuse and 86% of diffuse large cell complete responders alive and disease free at 7 years. Survival was similar with both regimens except for patients with diffuse large cell lymphoma who survived longer with CAVP. Both regimens were equitoxic with neutropenia less than 1.0 x 10(9)/liter in 36% of courses, infections in 15% of courses, and fatal infections in three patients. These intermittent high dose cyclophosphamide equitoxic regimens produced durable responses. However, the doxorubicin-containing regimen is superior in diffuse large cell lymphoma.
93例Ⅲ期和Ⅳ期非霍奇金淋巴瘤患者被随机分为两组，分别接受高剂量CVP方案（环磷酰胺1500mg/m²静脉注射第1天，长春新碱1.4mg/m²第1天，泼尼松40mg/m²口服第1 - 10天）或高剂量CAVP方案（环磷酰胺1000mg/m²静脉注射第1天，阿霉素45mg/m²静脉注射第1天，长春新碱和泼尼松同前）。总体而言，完全缓解（CR）率相似（CVP方案为51%，CAVP方案为51%）。国际工作分类中的弥漫性大细胞淋巴瘤患者接受CAVP方案时CR率显著更高。两种方案之间未检测到CR持续时间的差异。CR是持久的，7年时68%的弥漫性和86%的弥漫性大细胞完全缓解者存活且无疾病。除弥漫性大细胞淋巴瘤患者CAVP方案存活时间更长外，两种方案的生存率相似。两种方案毒性相当，36%的疗程中性粒细胞减少低于1.0×10⁹/L，15%的疗程发生感染，3例患者发生致命感染。这些间歇性高剂量环磷酰胺等毒性方案产生了持久的缓解。然而，含阿霉素的方案在弥漫性大细胞淋巴瘤中更具优势。
