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Multicenter phase II study of the CyclOBEAP (CHOP-like + etoposide and bleomycin) regimen for patients with poor-prognosis aggressive lymphoma

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Abstract

Our aim was to study the efficacy of the addition of etoposide and bleomycin to a [cyclophosphamide (CPA), doxorubicin (DXR), vincristine (VCR), and prednisone (PDN)] CHOP-like regimen for the treatment of aggressive lymphoma. The CyclOBEAP regimen was administered over a total period of 12 weeks. Doxorubicin, 50 mg/m2, was given every 2 weeks in combination with either cyclophosphamide, 1,000 mg/m2, (weeks 1, 5, 9) or etoposide, 70 mg/m2 qd ×4 (weeks 3, 7, 11). During the alternate weeks, non-myelosuppressive vincristine, 1.4 mg/m2 (maximum, 2.0 mg/body), was given either with bleomycin, 10 mg/m2 (weeks 2, 6, 10), or alone (weeks 4,8,12). Prednisolone, 40 mg/m2, was administered daily for 14 days during weeks 1–2, 5–6, and 9–10. There were 121 eligible patients and median age of 51 years. A complete response was achieved in 106 patients (88%) and a partial response in 11 patients. The 5-year overall survival (OS) rate was 72% and progression-free survival (PFS) rate was 62%. When the patients were divided according to the International Prognostic Index (IPI), the 5-year OS and PFS rates did not significantly differ among risk groups. When the patients with DLBCL were divided according to the IPI, the 5-year OS and PFS rates also did not significantly differ. World Health Organization (WHO) grade 4 neutropenia was observed in 91 patients and thrombocytopenia in 13 patients. No treatment-related deaths were observed. The addition of etoposide and bleomycin to CHOP therapy may enhance the effect of CHOP therapy for aggressive lymphoma. We will perform a prospective study of CyclOBEAP regimen combined with rituximab and test its safety and efficacy.

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Acknowledgements

We thank Dr. Nakamine, Dr. S. Nakamura, Dr. Oshima, Dr. Tamaru, and Dr. N. Nakamura for performing the pathological diagnosis.

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Authors and Affiliations

  1. Hematology Division Department of Internal Medicine, Saitama Medical School, 38 Morohongo, Moroyama, Iruma-Gun, Saitama, Japan

    Nozomi Niitsu

  2. The Adult Lymphoma Treatment Study Group: ALTSG, Saitama, Japan

    Nozomi Niitsu, Masataka Okamoto, Sadao Aoki, Hirokazu Okumura, Tadashi Yoshino, Ikuo Miura & Masami Hirano

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  1. Nozomi Niitsu
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  2. Masataka Okamoto
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  3. Sadao Aoki
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  4. Hirokazu Okumura
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  7. Masami Hirano
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Correspondence to Nozomi Niitsu.

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Niitsu, N., Okamoto, M., Aoki, S. et al. Multicenter phase II study of the CyclOBEAP (CHOP-like + etoposide and bleomycin) regimen for patients with poor-prognosis aggressive lymphoma. Ann Hematol 85, 374–380 (2006). https://doi.org/10.1007/s00277-006-0080-x

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