65177
document
LNH-84 regimen : a multicenter study of intensive chemotherapy in 737 patients with aggressive malignant lymphoma . From July 1984 to September 1987 , 737 patients with aggressive malignant lymphoma ( ML ) were treated by an intensive regimen ( LNH-84 ) comprising three or four courses of doxorubicin , 75 mg/m2 ; cyclophosphamide , 1,200 mg/m2 ; vindesine , 2 mg/m2 x 2 ; bleomycin , 10 mg x 2 ; and prednisolone , 60 mg/m2 x 5 ( ACVB ) , consolidation with high-dose methotrexate , ifosfamide , etoposide , asparaginase , and cytarabine , and a randomized late intensification with two courses of cytarabine , cyclophosphamide , teniposide , bleomycin , and prednisone ( AraCVmB ) . Four hundred forty-two patients had intermediate-grade ML , 221 highgrade ML , and 74 unclassified ML . Most of the patients had advanced disease : stage IIE ( 23 % ) , III ( 13 % ) , or IV ( 47 % ) ; 38 % disseminated nodes ; 38 % two or more extranodal sites ; and 41 % a tumoral mass greater than 10 cm . Five hundred fifty-three patients ( 75 % ) went into complete remission ( CR ) , 63 ( 9 % ) into partial remission , 62 ( 8 % ) failed to respond , and 59 ( 8 % ) died during ACVB courses , 17 of them from progression of the disease . With a median follow-up of 23 months , the estimated 2-year overall survival time to failure ( TTF ) , and time to relapse ( TTR ) survival are 67 % , 56 % , and 67 % , respectively . Patients receiving a late intensification had the same relapse rate as the other patients . A persistent fibronecrotic mass was found in 150 patients ( 20 % ) and did not influence the relapse rate . Toxicity was mainly neutropenia and infection during the ACVB courses , with 40 patients ( 5 % ) dying from septic complications while responding to treatment . Fifty-three percent of the patients had a neutropenia less than 0.500 x 10 ( 9 ) /L , 58 % fever ( 6 % grade 4 ) , and 49 % a documented infection ( 8 % grade 4 ) . These results obtained with the LNH-84 regimen demonstrate that this therapeutic scheme is an effective treatment for aggressive ML .
65178
Intervention_Pharmacological
intensive regimen ( LNH-84 )
65179
Intervention_Pharmacological
doxorubicin
65180
Intervention_Pharmacological
cyclophosphamide
65181
Intervention_Pharmacological
vindesine
65182
Intervention_Pharmacological
bleomycin
65183
Intervention_Pharmacological
prednisolone
65184
Intervention_Pharmacological
methotrexate , ifosfamide , etoposide , asparaginase , and cytarabine
65185
Intervention_Pharmacological
cytarabine , cyclophosphamide , teniposide , bleomycin , and prednisone
65186
Outcome_Physical
complete remission ( CR )
65187
Outcome_Physical
partial remission
65188
Outcome_Physical
failed to respond
65189
Outcome_Mortality
died
65190
Outcome_Mortality
overall survival time to failure ( TTF )
65191
Outcome_Mortality
time to relapse ( TTR ) survival
65192
Outcome_Physical
relapse rate
65193
Outcome_Physical
persistent fibronecrotic mass
65194
Outcome_Physical
relapse rate .
65195
Outcome_Adverse-effects
Toxicity
65196
Outcome_Adverse-effects
neutropenia
65197
Outcome_Adverse-effects
infection
65198
Outcome_Mortality
dying from septic complications
65199
Outcome_Adverse-effects
neutropenia
65200
Outcome_Physical
documented infection
65201
Participant_Age
Four hundred forty-two patients