Randomized study comparing doxorubicin, cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (ACOMLA) with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-B) in the treatment of diffuse histiocytic lymphoma

• Published in: Cancer treatment reports Vol. 66; no. 6; p. 1279
• Main Authors: Newcomer, L N, Cadman, E C, Nerenberg, M I, Chen, M, Bertino, J R, Farber, L R, Prosnitz, L R
• Format: Journal Article
• Language: English
• Published: United States 01-06-1982
• Subjects: Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Antineoplastic Combined Chemotherapy Protocols; Bleomycin - administration & dosage; Bleomycin - adverse effects; Clinical Trials as Topic; Cyclophosphamide - administration & dosage; Cyclophosphamide - adverse effects; Cytarabine - administration & dosage; Cytarabine - adverse effects; Doxorubicin - administration & dosage; Doxorubicin - adverse effects; Drug Therapy, Combination; Humans; Leucovorin - administration & dosage; Leucovorin - adverse effects; Lymphoma, Large B-Cell, Diffuse - drug therapy; Methotrexate - administration & dosage; Methotrexate - adverse effects; Prednisone - administration & dosage; Prednisone - adverse effects; Prognosis; Random Allocation; Vincristine - administration & dosage; Vincristine - adverse effects
• ISSN: 0361-5960

Two combination chemotherapy programs, ACOMLA (doxorubicin, cyclophosphamide, vincristine, methotrexate and leucovorin rescue, and cytarabine) and CHOP-B (cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin), were evaluated in 29 prospective randomized patients with advanced diffuse histiocytic lymphoma. A complete response was achieved in 13 of the 15 patients (87%) treated with CHOP-B and in nine of the 14 patients (64%) treated with ACOMLA. The overall complete response rate was 75%. Two patients treated with ACOMLA and none of the CHOP-B-treated patients have relapsed. Median followup is 32 months for ACOMLA patients and 26 months for CHOP-B patients. Actuarial freedom from relapse at 2 years is 49.9% for ACOMLA and 93.3% for CHOP-B (P = 0.04). Toxicity was substantial, with eight nonfatal episodes of sepsis and three drug-related deaths. There have been no central nervous system relapses. Although patients treated with CHOP-B have a better response rate, the small numbers of patients treated to date preclude definitive conclusions.