Journal of Clinical Oncology, Vol 5, 867-874, Copyright © 1987 by American Society of Clinical Oncology
Stage III follicular lymphoma: durable remissions with a combined chemotherapy-radiotherapy regimen
P McLaughlin, LM Fuller, WS Velasquez, JJ Butler, FB Hagemeister, JA Sullivan- Halley and DO Dixon
From 1975 to 1982, 74 patients with stage III follicular lymphoma were
treated with a combined modality protocol which included chemotherapy with
cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin
(CHOP-Bleo), and radiotherapy to involved regions. This program resulted in
a complete remission (CR) rate of 81%, a 5-year survival of 75%, and 5-year
relapse-free survival (RFS) of 52% for all patients. Analysis of potential
factors affecting treatment outcome revealed a significantly better CR rate
for patients with small cleaved cell type (97%) than for patients with
mixed (73%) or large-cell (57%) histologies. The 5-year survival was
significantly better for patients with small cleaved (91%) and mixed (84%)
cell types than for large cell (40%). In addition, bulky abdominal disease
and elevated serum lactate dehydrogenase (LDH) were significant adverse
prognostic factors for CR and for survival. Toxicity was moderate. No
secondary leukemias have occurred. This combined modality regimen resulted
in prolonged remission and potential cure for over half of patients who
achieved CR, and is particularly encouraging for those with follicular
small cleaved and mixed histologies.
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