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Annals of Oncology 8:S67-S70, 1997
© 1997 European Society for Medical Oncology

Persistent improved results after adding vincristine and bleomycin to a cyclophosphamide/hydroxorubicin/Vm-26/prednisone combination (CHVmP) in stage III-IV intermediate- and high-grade non-Hodgkin's lymphoma

J. H. Meerwaldt1, P. Carde2, R. Somers3, J. Thomas4, J. C. Kluin-Nelemans5, D. Bron6, E. M. Noordijk5, J. M. Cosset7, L. Bijnens8, I. Teodorovic8 on behalf of the EORTC Lymphoma Cooperative Group, A. Hagenbeek9 on behalf of the EORTC Lymphoma Cooperative Group

1 Medisch Spectrum Twente Enschede, the Netherlands
2 Institute Gustave Roussy Villjuif France
3 Antonie van Leeuwenhoek Hospital Amsterdam, the Netherlands
4 University Hospital Leuven, Belgium
5 Academic Hospital Leiden Leiden, the Netherlands
6 Hospital Jules Bordet Brussels, Belgium
7 Institute Curie Paris, France
8 EORTC Data Center Brussels, Belgium
9 Daniel den Hoed Cancer Center Rotterdam, the Netherlands

1Correspondence to: Dr. J. H. Meerwaldt Medisch Spectrum Twente Department of Radiotherapy P.O. Box 50000 7500 KA Enschede The Netherlands

CHOP has been and still is regarded by many as the ‘standard’ treatment of advanced non-Hodgkin's lymphoma. In 1980 the EORTC Lymphoma Cooperative Group started a study to evaluate the addition of vincristine and bleomycin to its standard four-drug combination chemotherapy, CHVmP (cyclophosphamide, hydroxorubicin, Vm-26, prednisone). Eligible patients were stage III or IV, intermediate- to high-grade non-Hodgkin's lymphoma (Working Formulation E-I).

One-hundred-eighty-nine patients were entered, of whom 140 were eligible and evaluable. A previous report showed an improved response rate and failure-free survival (FFS) and overall survival for the combination CHVmP-VB.

At ten years, the outcome still favors the addition of vincristine and bleomycin. The FFS was 34% vs. 23% and the overall survival 34% vs. 22%. This difference was mainly due to a difference in CR rate (74% vs. 49%), Relapse-free survival for patients reaching a CR was the same in both arms.

When the patients were grouped according to the International Prognostic Factor Index, no statistically significant difference could be observed in favor of one treatment within either group.

This trial clearly demonstrates the benefit gained by the addition of vincristine and bleomycin to ‘standard’ chemotherapy for intermediate and high-grade non-Hodgkin's lymphoma.

chemotherapy, CHVmP-VB, EORTC, intermediate/high-grade, non-Hodgkin's lymphoma


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