Parlier Y, Gorin N C, Stachowiak J, Najman A, Duhamel G
Sem Hop. 1981;57(41-42):1685-90.
One hundred and thirty one patients with non-Hodgkin's lymphomas (107 lymphomas and 24 histiocytic lymphomas) have been treated between January 1973 and January 1976, by an association of cyclophosphamide, vincristine and prednisone alone (CVP) or combined with adriamycin (CVP-A). All lymphomas stage I and II received CVP + radiotherapy: the actuarial analysis shows a stationary survival from 1 to 5 years at 89%. In the group of lymphoid lymphomas stage III and IV with nodular pattern, the survival is longer for patients who received CVP (69% at five years) than for patients treated with CVP-A (54% at three years). In the group of lymphoid lymphomas stage III and IV with diffuse pattern, the complete remission rate is 25% for the CVP and 67% for the CVP-A (p less than 0.01). However, the median duration of life is not different for the two groups (24 and 26 months respectively). In the group of histiocytic lymphomas, the complete remission rate in 50% for the CVP combination and 83% for the CPV-A. However, the median time of life which is 17 months for the CVP, is not reached for the CVP-A (Stationary survival at 90% from the 12th to the 36th months). These results show that the CVP combination is a good treatment for the lymphoïd lymphoma with nodular pattern. The addition of adriamycin gives hope of long remissions and perhaps cure for histiocytic lymphomas, until now of bad prognosis. For the lymphoid lymphoma with diffuse pattern, the prognosis is still bad although we obtained with adriamycin a better rate of complete remission. The high dose chemotherapy rescued by autologous bone marrow transplantation may be a new possibility for this last type of non Hodgkin lymphomas.
1973年1月至1976年1月期间,131例非霍奇金淋巴瘤患者(107例淋巴瘤和24例组织细胞性淋巴瘤)接受了仅用环磷酰胺、长春新碱和泼尼松联合治疗(CVP)或联合阿霉素治疗(CVP-A)。所有Ⅰ期和Ⅱ期淋巴瘤患者接受CVP + 放疗:精算分析显示1至5年的生存率稳定在89%。在Ⅲ期和Ⅳ期结节型淋巴样淋巴瘤组中,接受CVP治疗的患者生存率更高(五年生存率为69%),高于接受CVP-A治疗的患者(三年生存率为54%)。在Ⅲ期和Ⅳ期弥漫型淋巴样淋巴瘤组中,CVP方案的完全缓解率为25%,CVP-A方案为67%(p小于0.01)。然而,两组的中位生存期无差异(分别为24个月和26个月)。在组织细胞性淋巴瘤组中,CVP联合方案的完全缓解率为50%,CPV-A方案为83%。然而,CVP组的中位生存期为17个月,CVP-A组未达到(第12至36个月生存率稳定在90%)。这些结果表明,CVP联合方案是治疗结节型淋巴样淋巴瘤的良好方法。添加阿霉素有望实现长期缓解,甚至可能治愈预后一直较差的组织细胞性淋巴瘤。对于弥漫型淋巴样淋巴瘤,尽管使用阿霉素获得了更高的完全缓解率,但预后仍然较差。自体骨髓移植挽救的高剂量化疗可能是治疗这种最后一种类型非霍奇金淋巴瘤的新选择。