Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-hodgkin's lymphomas

Andrew M. Schneider, David J. Straus, Alice E. Schluger, Dennis A. Lowenthal, Benjamin Koziner, J. Lee Burton, George Wong, Bayard D. Clarkson

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Abstract

Seventy previously untreated patients with stage II, III, and IV intermediate- or high-grade lymphoma were treated with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) between September 1985 and November 1987. Forty-nine of these patients had diffuse large-cell lymphoma (DLCL), and eight of these patients were human immunodeficiency virus (HIV)-positive. Complete responses were achieved in 54% of all patients and 52% of those with DLCL. With follow-up extending to 36 months, 45% of all DLCL patients are alive, and 50% are still living, if the HIV-positive patients are excluded from the analysis. Chemotherapy was quite toxic. Seventy-five percent of patients had severe mucositis, 42% had peripheral neuropathy, 50% required hospitalization, and 54% experienced leukopenia with a WBC count below 1,000/μL. Seven percent (five patients) died of toxicity related to the chemotherapy. Our analysis of prognostic parameters indicated that B symptoms, a performance status below 80, and, to a lesser extent, elevation of serum lactic acid dehydrogenase (LDH) (in HIV-negative DLCL patients) were associated with an inferior survival. Advanced age, sex, and bulky disease were not found to have a statistically significant effect on survival. Our preliminary results indicate that MACOP-B chemotherapy is an effective regimen for high- and intermediate-grade lymphomas. However, the survival for patients with DLCL treated with MACOP-B is no different than that achieved with previous regimens at our institution.

Original languageEnglish (US)
Pages (from-to)94-102
Number of pages9
JournalJournal of Clinical Oncology
Volume8
Issue number1
DOIs
StatePublished - Jan 1 1990

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Bleomycin
Vincristine
Prednisone
Methotrexate
Non-Hodgkin's Lymphoma
Doxorubicin
Cyclophosphamide
Lymphoma, Large B-Cell, Diffuse
Therapeutics
HIV
Drug Therapy
Survival
Mucositis
Poisons
Leukopenia
Peripheral Nervous System Diseases
Lactic Acid
Oxidoreductases
Hospitalization

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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Schneider, Andrew M. ; Straus, David J. ; Schluger, Alice E. ; Lowenthal, Dennis A. ; Koziner, Benjamin ; Burton, J. Lee ; Wong, George ; Clarkson, Bayard D. / Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-hodgkin's lymphomas. In: Journal of Clinical Oncology. 1990 ; Vol. 8, No. 1. pp. 94-102.
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abstract = "Seventy previously untreated patients with stage II, III, and IV intermediate- or high-grade lymphoma were treated with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) between September 1985 and November 1987. Forty-nine of these patients had diffuse large-cell lymphoma (DLCL), and eight of these patients were human immunodeficiency virus (HIV)-positive. Complete responses were achieved in 54{\%} of all patients and 52{\%} of those with DLCL. With follow-up extending to 36 months, 45{\%} of all DLCL patients are alive, and 50{\%} are still living, if the HIV-positive patients are excluded from the analysis. Chemotherapy was quite toxic. Seventy-five percent of patients had severe mucositis, 42{\%} had peripheral neuropathy, 50{\%} required hospitalization, and 54{\%} experienced leukopenia with a WBC count below 1,000/μL. Seven percent (five patients) died of toxicity related to the chemotherapy. Our analysis of prognostic parameters indicated that B symptoms, a performance status below 80, and, to a lesser extent, elevation of serum lactic acid dehydrogenase (LDH) (in HIV-negative DLCL patients) were associated with an inferior survival. Advanced age, sex, and bulky disease were not found to have a statistically significant effect on survival. Our preliminary results indicate that MACOP-B chemotherapy is an effective regimen for high- and intermediate-grade lymphomas. However, the survival for patients with DLCL treated with MACOP-B is no different than that achieved with previous regimens at our institution.",
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Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-hodgkin's lymphomas. / Schneider, Andrew M.; Straus, David J.; Schluger, Alice E.; Lowenthal, Dennis A.; Koziner, Benjamin; Burton, J. Lee; Wong, George; Clarkson, Bayard D.

In: Journal of Clinical Oncology, Vol. 8, No. 1, 01.01.1990, p. 94-102.

Research output: Contribution to journalArticle

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T1 - Treatment results with an aggressive chemotherapeutic regimen (MACOP-B) for intermediate- and some high-grade non-hodgkin's lymphomas

AU - Schneider, Andrew M.

AU - Straus, David J.

AU - Schluger, Alice E.

AU - Lowenthal, Dennis A.

AU - Koziner, Benjamin

AU - Burton, J. Lee

AU - Wong, George

AU - Clarkson, Bayard D.

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N2 - Seventy previously untreated patients with stage II, III, and IV intermediate- or high-grade lymphoma were treated with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) between September 1985 and November 1987. Forty-nine of these patients had diffuse large-cell lymphoma (DLCL), and eight of these patients were human immunodeficiency virus (HIV)-positive. Complete responses were achieved in 54% of all patients and 52% of those with DLCL. With follow-up extending to 36 months, 45% of all DLCL patients are alive, and 50% are still living, if the HIV-positive patients are excluded from the analysis. Chemotherapy was quite toxic. Seventy-five percent of patients had severe mucositis, 42% had peripheral neuropathy, 50% required hospitalization, and 54% experienced leukopenia with a WBC count below 1,000/μL. Seven percent (five patients) died of toxicity related to the chemotherapy. Our analysis of prognostic parameters indicated that B symptoms, a performance status below 80, and, to a lesser extent, elevation of serum lactic acid dehydrogenase (LDH) (in HIV-negative DLCL patients) were associated with an inferior survival. Advanced age, sex, and bulky disease were not found to have a statistically significant effect on survival. Our preliminary results indicate that MACOP-B chemotherapy is an effective regimen for high- and intermediate-grade lymphomas. However, the survival for patients with DLCL treated with MACOP-B is no different than that achieved with previous regimens at our institution.

AB - Seventy previously untreated patients with stage II, III, and IV intermediate- or high-grade lymphoma were treated with methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B) between September 1985 and November 1987. Forty-nine of these patients had diffuse large-cell lymphoma (DLCL), and eight of these patients were human immunodeficiency virus (HIV)-positive. Complete responses were achieved in 54% of all patients and 52% of those with DLCL. With follow-up extending to 36 months, 45% of all DLCL patients are alive, and 50% are still living, if the HIV-positive patients are excluded from the analysis. Chemotherapy was quite toxic. Seventy-five percent of patients had severe mucositis, 42% had peripheral neuropathy, 50% required hospitalization, and 54% experienced leukopenia with a WBC count below 1,000/μL. Seven percent (five patients) died of toxicity related to the chemotherapy. Our analysis of prognostic parameters indicated that B symptoms, a performance status below 80, and, to a lesser extent, elevation of serum lactic acid dehydrogenase (LDH) (in HIV-negative DLCL patients) were associated with an inferior survival. Advanced age, sex, and bulky disease were not found to have a statistically significant effect on survival. Our preliminary results indicate that MACOP-B chemotherapy is an effective regimen for high- and intermediate-grade lymphomas. However, the survival for patients with DLCL treated with MACOP-B is no different than that achieved with previous regimens at our institution.

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