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Annals of Oncology 4:205-211, 1993
© 1993 European Society for Medical Oncology

research-article

CHOP-Bleo plus interferon for stage IV low-grade lymphoma

P. McLaughlin1,, F. Cabanillas1, F. B. Hagemeister1, F. Swan, Jr.1, J. E. Romaguera1, S. Taylor1, M. A. Rodriguez1, W. S. Velasquez1, J. R. Redman1 and J. U. Gutterman2

1Department of Hematology, Section of Lymphoma
2Department of Clinical Immunology and Biological Therapy, The University of Texas, M.D. Anderson Cancer Center Houston, Texas, U.S.A.

Peter McLaughlin, M.D. Department of Hematology, Box 68, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe, Houston, Texas 77030, U.S.A.

BACKGROUND: Alpha interferon (IFN) is an effective single agent for patients with low-grade lymphoma, but until 1982 had not been integrated with standard chemotherapy for these patients. Since relapse from complete remission (CR) is the rule for patients with advanced stage low-grade lymphoma, a maintenance IFN schedule was explored for patients in CR.

PATIENTS AND METHODS: From 1982–1987, 127 patients with stage IV low-grade lymphoma were treated with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-Bleo) for 9–18 mo. (median 13 mo.), followed by interferon alfa-n-1 (Wellferon®) maintenance therapy for 24 mo. for CRs.

RESULTS: The overall response rate for the entire treatment program was 73% CR and 23% partial remission. The median follow up was 59 months. At 5 years, survival was 74%, failure-free survival (FFS) 47%, and FFS of CRs 60%. Compared to a group of 96 patients with similar pretreatment clinical features treated with CHOP-Bleo from 1972–1982, this represents a significant improvement for both overall FFS (p – 0.01) and FFS of CRs (P < 0.01). Toxicity from the IFN maintenance was generally acceptable, but even at the modest dose employed in this trial (3 x 106 U/m2 three times weekly), dose modification was required in more than 30% of patients, usually because of fatigue.

CONCLUSIONS: The integration of IFN and conventional chemotherapy is feasible and effective. Maintenance IFN prolongs remission duration for patients with stage IV low-grade lymphoma.

{alpha}-interferon, chemotherapy, malignant lymphoma, low-grade lymphoma


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