Ohnoshi T, Hayashi K, Ueno K, Tada A, Mizuta J, Tagawa S, Matsutomo S, Saito S, Kawashima K, Yoshino T
Second Department of Medicine, Okayama University Medical School, Japan.
Int J Hematol. 1993 Aug;58(1-2):93-8.
Diffuse large-cell lymphoma (DLCL) is a neoplasm that is curable with chemotherapy in an appreciable percentage of patients. However, not all patients are cured and the best drug combination and optimal dose intensity have not yet been established. In an attempt to improve complete response rate and survival with minimal toxicity, we devised an alternating combination chemotherapy consisting of CHOP-Bleo (cyclophosphamide, doxorubicin, vincristine, prednisolone, and bleomycin) and POEM-Bleo (prednisolone, vincristine, etoposide, mitoxantrone, and bleomycin). Between March 1986 and October 1990, 30 newly-diagnosed patients with advanced DLCL were treated with the regimen. Of these 30 patients, 14 (47%) were 61 years of age or more, 15 (50%) had stage IV disease, 14 (47%) presented with constitutional symptoms, and 7 (23%) had T-cell lymphoma. After the completion of therapy, 23 (77%) achieved a complete response and 6 (20%) had a partial response. The actuarial relapse-free survival at 5 years is 52% and the overall survival projected to 5 years is 47%. Toxicity was generally mild and well tolerated. Although this alternating regimen had substantial activity as front-line chemotherapy for advanced DLCL, we conclude that the observed response rate and survival do not essentially differ from those achieved with conventional regimens and further clinical trials are thus not warranted.
弥漫性大细胞淋巴瘤（DLCL）是一种肿瘤，相当比例的患者可通过化疗治愈。然而，并非所有患者都能治愈，最佳的药物组合和最佳剂量强度尚未确定。为了以最小的毒性提高完全缓解率和生存率，我们设计了一种交替联合化疗方案，包括CHOP - 博来霉素（环磷酰胺、阿霉素、长春新碱、泼尼松龙和博来霉素）和POEM - 博来霉素（泼尼松龙、长春新碱、依托泊苷、米托蒽醌和博来霉素）。1986年3月至1990年10月，30例新诊断的晚期DLCL患者接受了该方案治疗。在这30例患者中，14例（47%）年龄在61岁及以上，15例（50%）为IV期疾病，14例（47%）有全身症状，7例（23%）为T细胞淋巴瘤。治疗结束后，23例（77%）达到完全缓解，6例（20%）部分缓解。5年的无病生存率为52%，预计5年总生存率为47%。毒性一般较轻，耐受性良好。虽然这种交替方案作为晚期DLCL的一线化疗有显著活性，但我们得出结论，观察到的缓解率和生存率与传统方案相比并无本质差异，因此无需进一步进行临床试验。
