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

Fingerprint

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.
@article{7635ef4c8ba44491a1949aba6a1b8405,
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.",
author = "Shahin Rafi and Morton Coleman and Thomas Kaufmann and Gabriella Cesarman and Steven Papish and Bernard Bernhart and Mitchell Gaynor and Reisman, {Arlene M.}",
year = "1997",
month = "2",
day = "1",
doi = "10.1097/00000421-199702000-00021",
language = "English (US)",
volume = "20",
pages = "90--96",
journal = "American Journal of Clinical Oncology",
issn = "0277-3732",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

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.

UR - http://www.scopus.com/inward/record.url?scp=0031025438&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031025438&partnerID=8YFLogxK

U2 - 10.1097/00000421-199702000-00021

DO - 10.1097/00000421-199702000-00021

M3 - Article

VL - 20

SP - 90

EP - 96

JO - American Journal of Clinical Oncology

JF - American Journal of Clinical Oncology

SN - 0277-3732

IS - 1

ER -