Gopal R, Nair R, Saikia T K, Soman C S, Dinshaw K A, Advani S H
Dept. of Medical Oncology, Tata Memorial Hospital, Parel, Bombay.
J Assoc Physicians India. 1994 Oct;42(10):781-4.
Combination chemotherapy consisting of methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisolone and bleomycin (MACOP-B) has been extensively used for the treatment of Non Hodgkins Lymphoma. However, different results have been reported. The aim of this study was to assess the feasibility of administration of this regimen on an out patient basis and to confirm the efficacy of MACOP-B. 51 patients with intermediate--and high--grade lymphoma were treated with this regimen in a single institute study. Numerous clinical features predictive of response and disease free survival were analysed. The Median age was 48 years (range 14-77). Diffuse large cell lymphoma was seen in 65%, diffuse small cleaved in 10% and diffuse mixed in 15%. Eight patients (15%) had Stage I disease, 18 (35%) Stage II, 12 (23%) Stage III and 13 (25%) Stage IV. Complete remission was achieved in 65% of the patients. With a median follow up of 18 months, 40% of the patients are alive at 40 months. Sixty percent of the complete responders are disease free at 40 months. Response rates did not differ significantly for age, sex, stage, histology, bone marrow involvement and extranodal disease. However patients with absence of B' symptoms, non bulky disease at presentation and diffuse large cell histology had a higher percentage of complete remission. Hematological toxicity occurred in 90% and was grade IV in 14% patients. Three patients died of sepsis. Severe mucositis occurred in 40% of the patients. In conclusion, while it is possible to give aggressive chemotherapy at the out patient basis in India we failed to confirm the high response rates as originally reported.
由甲氨蝶呤加亚叶酸钙解救、阿霉素、环磷酰胺、长春新碱、强的松龙和博来霉素组成的联合化疗方案（MACOP - B）已被广泛用于治疗非霍奇金淋巴瘤。然而，报道的结果各不相同。本研究的目的是评估该方案在门诊给药的可行性，并证实MACOP - B方案的疗效。在一项单机构研究中，51例中、高度淋巴瘤患者接受了该方案治疗。分析了许多预测缓解和无病生存的临床特征。中位年龄为48岁（范围14 - 77岁）。65%为弥漫性大细胞淋巴瘤，10%为弥漫性小裂细胞淋巴瘤，15%为弥漫性混合细胞淋巴瘤。8例（15%）为Ⅰ期疾病，18例（35%）为Ⅱ期，12例（23%）为Ⅲ期，13例（25%）为Ⅳ期。65%的患者实现了完全缓解。中位随访18个月时，40%的患者在40个月时仍存活。60%的完全缓解者在40个月时无病。年龄、性别、分期、组织学、骨髓受累和结外疾病的缓解率无显著差异。然而，没有B症状、初诊时疾病不广泛且组织学为弥漫性大细胞的患者完全缓解的比例更高。90%的患者发生血液学毒性，14%的患者为Ⅳ级。3例患者死于败血症。40%的患者发生严重粘膜炎。总之，虽然在印度门诊进行积极化疗是可行的，但我们未能证实最初报道的高缓解率。
