CODBLAM IV chemotherapy for large cell lymphoma: Sequential use of infusional vincristine and bleomycin and 'high dose' consolidation

Shahin Rafi, Morton Coleman, Thomas Kaufmann, Gabriella Cesarman, Steven Papish, Bernard Bernhart, Mitchell Gaynor, Arlene M. Reisman

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: Based on prior results in large cell lymphoma (LCL) with COPBLAM (Cyclophosphamide, Oncovin, Prednisone, Bleomycin, Adriamycin, Matulane) I and COPBLAM III, CODBLAM (Cyclophosphamide, Oncovin, Dexamethasone, Bleomycin, Adriamycin, Matulane) IV was developed to intensify treatment further by utilizing four sequential cycles of infusional chemotherapy followed by high-dose chemotherapy and cycle active agents. Methods: Sixty-one patients with LCL, mostly B-cell lymphoma, with 54% >60 years of age, were treated with daily continuous infusion of vincristine 1.0 mg/m2 days 1-2, bleomycin 4 mg/m2 i.v. push x 1 only followed by daily infusion 4 mg/m2 days 1-5, dexamethasone 10 mg/m2 days 1-5, procarbazine 100 mg/m2 orally days 1-5, doxorubicin 35 mg/m2 i.v. push day 1 (escalated), and cyclophosphamide 350 mg/m2 i.v. push day 1 (escalated), all given every 3 weeks for four cycles. After infusions, patients were restaged and treated with single courses of doxorubicin 90 mg/m2 i.v. push followed at 3 weeks with cyclophosphamide 1500 mg/m2 i.v. push (both with concomitant vincristine 1 mg/m2 i.v. push and dexamethasone 10 mg/m2 p.o. daily for 5 days). Remaining treatment consisted of methotrexate 120 mg/m2 i.v. push with citrovorum rescue, cytarabine 250 mg/m2 i.v. push, and etoposide 100 mg/m2 i.v. infusion over 1 h, all given every 10 days for six cycles. Results: The overall complete response (CR) rate was 88%. Of all patients, 36 (59%) are sustained disease free at a median follow-up time of 55 months. In patients age ≤60 years, 89% achieved CR and 85% of patients age >60 years attained CR. CR was achieved in 83% of patients with constitutional B-type symptoms, 69% of patients with bulky adenopathy, and 86% of patients with immunoblastic histology. Toxicity was primarily pulmonary, occurring in 15% of patients. One toxic death was observed. Conclusions: Infusional CODBLAM IV may represent an effective and unique treatment for LCL.

Original languageEnglish (US)
Pages (from-to)90-96
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume20
Issue number1
DOIs
StatePublished - Feb 1 1997

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Procarbazine
Bleomycin
Vincristine
Doxorubicin
Cyclophosphamide
Dexamethasone
Lymphoma
Drug Therapy
Prednisone
Poisons
Cytarabine
B-Cell Lymphoma
Etoposide
Methotrexate
Histology
Therapeutics
Lung

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Rafi, Shahin ; Coleman, Morton ; Kaufmann, Thomas ; Cesarman, Gabriella ; Papish, Steven ; Bernhart, Bernard ; Gaynor, Mitchell ; Reisman, Arlene M. / CODBLAM IV chemotherapy for large cell lymphoma : Sequential use of infusional vincristine and bleomycin and 'high dose' consolidation. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 1997 ; Vol. 20, No. 1. pp. 90-96.
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title = "CODBLAM IV chemotherapy for large cell lymphoma: Sequential use of infusional vincristine and bleomycin and 'high dose' consolidation",
abstract = "Background: Based on prior results in large cell lymphoma (LCL) with COPBLAM (Cyclophosphamide, Oncovin, Prednisone, Bleomycin, Adriamycin, Matulane) I and COPBLAM III, CODBLAM (Cyclophosphamide, Oncovin, Dexamethasone, Bleomycin, Adriamycin, Matulane) IV was developed to intensify treatment further by utilizing four sequential cycles of infusional chemotherapy followed by high-dose chemotherapy and cycle active agents. Methods: Sixty-one patients with LCL, mostly B-cell lymphoma, with 54{\%} >60 years of age, were treated with daily continuous infusion of vincristine 1.0 mg/m2 days 1-2, bleomycin 4 mg/m2 i.v. push x 1 only followed by daily infusion 4 mg/m2 days 1-5, dexamethasone 10 mg/m2 days 1-5, procarbazine 100 mg/m2 orally days 1-5, doxorubicin 35 mg/m2 i.v. push day 1 (escalated), and cyclophosphamide 350 mg/m2 i.v. push day 1 (escalated), all given every 3 weeks for four cycles. After infusions, patients were restaged and treated with single courses of doxorubicin 90 mg/m2 i.v. push followed at 3 weeks with cyclophosphamide 1500 mg/m2 i.v. push (both with concomitant vincristine 1 mg/m2 i.v. push and dexamethasone 10 mg/m2 p.o. daily for 5 days). Remaining treatment consisted of methotrexate 120 mg/m2 i.v. push with citrovorum rescue, cytarabine 250 mg/m2 i.v. push, and etoposide 100 mg/m2 i.v. infusion over 1 h, all given every 10 days for six cycles. Results: The overall complete response (CR) rate was 88{\%}. Of all patients, 36 (59{\%}) are sustained disease free at a median follow-up time of 55 months. In patients age ≤60 years, 89{\%} achieved CR and 85{\%} of patients age >60 years attained CR. CR was achieved in 83{\%} of patients with constitutional B-type symptoms, 69{\%} of patients with bulky adenopathy, and 86{\%} of patients with immunoblastic histology. Toxicity was primarily pulmonary, occurring in 15{\%} of patients. One toxic death was observed. Conclusions: Infusional CODBLAM IV may represent an effective and unique treatment for LCL.",
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CODBLAM IV chemotherapy for large cell lymphoma : Sequential use of infusional vincristine and bleomycin and 'high dose' consolidation. / Rafi, Shahin; Coleman, Morton; Kaufmann, Thomas; Cesarman, Gabriella; Papish, Steven; Bernhart, Bernard; Gaynor, Mitchell; Reisman, Arlene M.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 20, No. 1, 01.02.1997, p. 90-96.

Research output: Contribution to journalArticle

TY - JOUR

T1 - CODBLAM IV chemotherapy for large cell lymphoma

T2 - Sequential use of infusional vincristine and bleomycin and 'high dose' consolidation

AU - Rafi, Shahin

AU - Coleman, Morton

AU - Kaufmann, Thomas

AU - Cesarman, Gabriella

AU - Papish, Steven

AU - Bernhart, Bernard

AU - Gaynor, Mitchell

AU - Reisman, Arlene M.

PY - 1997/2/1

Y1 - 1997/2/1

N2 - Background: Based on prior results in large cell lymphoma (LCL) with COPBLAM (Cyclophosphamide, Oncovin, Prednisone, Bleomycin, Adriamycin, Matulane) I and COPBLAM III, CODBLAM (Cyclophosphamide, Oncovin, Dexamethasone, Bleomycin, Adriamycin, Matulane) IV was developed to intensify treatment further by utilizing four sequential cycles of infusional chemotherapy followed by high-dose chemotherapy and cycle active agents. Methods: Sixty-one patients with LCL, mostly B-cell lymphoma, with 54% >60 years of age, were treated with daily continuous infusion of vincristine 1.0 mg/m2 days 1-2, bleomycin 4 mg/m2 i.v. push x 1 only followed by daily infusion 4 mg/m2 days 1-5, dexamethasone 10 mg/m2 days 1-5, procarbazine 100 mg/m2 orally days 1-5, doxorubicin 35 mg/m2 i.v. push day 1 (escalated), and cyclophosphamide 350 mg/m2 i.v. push day 1 (escalated), all given every 3 weeks for four cycles. After infusions, patients were restaged and treated with single courses of doxorubicin 90 mg/m2 i.v. push followed at 3 weeks with cyclophosphamide 1500 mg/m2 i.v. push (both with concomitant vincristine 1 mg/m2 i.v. push and dexamethasone 10 mg/m2 p.o. daily for 5 days). Remaining treatment consisted of methotrexate 120 mg/m2 i.v. push with citrovorum rescue, cytarabine 250 mg/m2 i.v. push, and etoposide 100 mg/m2 i.v. infusion over 1 h, all given every 10 days for six cycles. Results: The overall complete response (CR) rate was 88%. Of all patients, 36 (59%) are sustained disease free at a median follow-up time of 55 months. In patients age ≤60 years, 89% achieved CR and 85% of patients age >60 years attained CR. CR was achieved in 83% of patients with constitutional B-type symptoms, 69% of patients with bulky adenopathy, and 86% of patients with immunoblastic histology. Toxicity was primarily pulmonary, occurring in 15% of patients. One toxic death was observed. Conclusions: Infusional CODBLAM IV may represent an effective and unique treatment for LCL.

AB - Background: Based on prior results in large cell lymphoma (LCL) with COPBLAM (Cyclophosphamide, Oncovin, Prednisone, Bleomycin, Adriamycin, Matulane) I and COPBLAM III, CODBLAM (Cyclophosphamide, Oncovin, Dexamethasone, Bleomycin, Adriamycin, Matulane) IV was developed to intensify treatment further by utilizing four sequential cycles of infusional chemotherapy followed by high-dose chemotherapy and cycle active agents. Methods: Sixty-one patients with LCL, mostly B-cell lymphoma, with 54% >60 years of age, were treated with daily continuous infusion of vincristine 1.0 mg/m2 days 1-2, bleomycin 4 mg/m2 i.v. push x 1 only followed by daily infusion 4 mg/m2 days 1-5, dexamethasone 10 mg/m2 days 1-5, procarbazine 100 mg/m2 orally days 1-5, doxorubicin 35 mg/m2 i.v. push day 1 (escalated), and cyclophosphamide 350 mg/m2 i.v. push day 1 (escalated), all given every 3 weeks for four cycles. After infusions, patients were restaged and treated with single courses of doxorubicin 90 mg/m2 i.v. push followed at 3 weeks with cyclophosphamide 1500 mg/m2 i.v. push (both with concomitant vincristine 1 mg/m2 i.v. push and dexamethasone 10 mg/m2 p.o. daily for 5 days). Remaining treatment consisted of methotrexate 120 mg/m2 i.v. push with citrovorum rescue, cytarabine 250 mg/m2 i.v. push, and etoposide 100 mg/m2 i.v. infusion over 1 h, all given every 10 days for six cycles. Results: The overall complete response (CR) rate was 88%. Of all patients, 36 (59%) are sustained disease free at a median follow-up time of 55 months. In patients age ≤60 years, 89% achieved CR and 85% of patients age >60 years attained CR. CR was achieved in 83% of patients with constitutional B-type symptoms, 69% of patients with bulky adenopathy, and 86% of patients with immunoblastic histology. Toxicity was primarily pulmonary, occurring in 15% of patients. One toxic death was observed. Conclusions: Infusional CODBLAM IV may represent an effective and unique treatment for LCL.

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