Longo D L, Duffey P L, Jaffe E S, Raffeld M, Hubbard S M, Fisher R I, Wittes R E, DeVita V T, Young R C
Division of Cancer Treatment, National Cancer Institute, Bethesda, MD.
J Clin Oncol. 1994 Oct;12(10):2153-9. doi: 10.1200/JCO.1994.12.10.2153.
To review the efficacy of cyclophosphamide, doxorubicin, etoposide, methotrexate with leucovorin, and prednisone (ProMACE)-based combination chemotherapy programs in the treatment of patients with diffuse small noncleaved-cell non-Burkitt's lymphoma.
Thirty-three patients with diffuse small noncleaved-cell non-Burkitt's lymphoma were accrued: eight with localized disease were treated with modified ProMACE-mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) plus involved-field radiation therapy, and 25 with advanced-stage disease were treated with ProMACE/MOPP flexitherapy (n = 8), ProMACE-MOPP (n = 9), or ProMACE-cytarabine, bleomycin, vincristine, and methotrexate with leucovorin (CytaBOM) (n = 8). The median follow-up duration is 10 years.
All eight patients with localized disease achieved a complete response, none have relapsed, and one died of intercurrent illness. Among patients with advanced-stage disease, five of eight (63%) flexitherapy-treated patients, six of nine (67%) ProMACE-MOPP-treated patients, and eight of eight (100%) ProMACE-CytaBOM-treated patients achieved a complete response. If the two ProMACE-MOPP-based groups are considered together, disease-free and overall survival rates at 15 years are projected at 61% and 35%, respectively. In contrast, only one patient has relapsed from a ProMACE-CytaBOM-induced complete remission, and overall survival of ProMACE-CytaBOM-treated patients (88%) is significantly higher than that for flexitherapy and ProMACE-MOPP (P2 = .04).
Adult patients with diffuse small non-cleaved-cell non-Burkitt's lymphoma may be effectively treated with regimens that are effective in other aggressive lymphomas (eg, diffuse large-cell lymphoma).
回顾以环磷酰胺、阿霉素、依托泊苷、甲氨蝶呤加亚叶酸钙以及泼尼松（ProMACE）为基础的联合化疗方案治疗弥漫性小无裂细胞非伯基特淋巴瘤患者的疗效。
共纳入33例弥漫性小无裂细胞非伯基特淋巴瘤患者：8例局限性疾病患者接受改良ProMACE - 氮芥、长春新碱、丙卡巴肼和泼尼松（MOPP）联合受累野放射治疗，25例晚期疾病患者接受ProMACE/MOPP灵活化疗（n = 8）、ProMACE - MOPP（n = 9）或ProMACE - 阿糖胞苷、博来霉素、长春新碱和甲氨蝶呤加亚叶酸钙（CytaBOM）（n = 8）治疗。中位随访时间为10年。
8例局限性疾病患者均获得完全缓解，无一例复发，1例死于并发疾病。在晚期疾病患者中，8例接受灵活化疗的患者中有5例（63%）、9例接受ProMACE - MOPP治疗的患者中有6例（67%）以及8例接受ProMACE - CytaBOM治疗的患者中有8例（100%）获得完全缓解。如果将两个基于ProMACE - MOPP的组合并考虑，预计15年无病生存率和总生存率分别为61%和35%。相比之下，ProMACE - CytaBOM诱导完全缓解后仅有1例患者复发，ProMACE - CytaBOM治疗患者的总生存率（88%）显著高于灵活化疗和ProMACE - MOPP治疗患者（P2 = 0.04）。
弥漫性小无裂细胞非伯基特淋巴瘤成年患者可用对其他侵袭性淋巴瘤（如弥漫性大细胞淋巴瘤）有效的方案进行有效治疗。
