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Treatment of diffuse large-cell lymphoma: A summary of outcome for patients treated by the Southwest Oncology Group

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Malignant lymphomas, including Hodgkin’s disease: Diagnosis, management, and special problems

Part of the book series: Cancer Treatment and Research ((CTAR,volume 66))

Abstract

Among the heterogeneous diseases classified as non-Hodgkin’s lymphomas (NHL), diffuse large-cell lymphoma (DLCL) is relatively common and is associated with a potential for cure following initial treatment with doxorubicin-containing chemotherapy. Consequently, DLCL has become a chosen target of investigators testing new therapies designed for cure. By choosing to study a single morphologic disease, and by standardizing procedures used to determine the extent of disease, comparisons of new therapies to historical experience seem appropriate. However, the past decade of clinical research designed to improve treatment for this disease has been characterized by extraordinary controversy. The proportion of cured patients with advanced stages of DLCL has been variably reported as 30–80% [1,2]. In this chapter we review the results of 20 years of investigations of the Southwest Oncology Group (SWOG) using doxorubicin-containing chemotherapy for DLCL to help determine the causes of controversy and the effectiveness of various chemotherapy programs.

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References

  1. Coltman CA, Dahlberg S, Jones SE, et al.: CHOP is curative in thirty percent of patients with large cell lymphoma: a twelve year Southwest Oncology Group follow-up. In AT Skarin, ed. Advances in Cancer Chemotherapy. New York: Park Row, 1986, pp 71–77.

    Google Scholar 

  2. Klimo P, Connors JM: MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma. Ann Intern Med 102:596–602, 1985.

    PubMed  CAS  Google Scholar 

  3. Coleman, M: Chemotherapy for large-cell lymphoma: Optimism and caution. Ann Intern Med 103:140–142, 1985.

    PubMed  CAS  Google Scholar 

  4. Skarin A, Canellos G, Rosenthal D, et al.: Moderate dose methotrexate combined with bleomycin, adriamycin, cyclophosphamide, Oncovin, and dexamethasome, m-BACOD, in advanced diffuse histiocytic lymphoma. Proc Am Soc Clin Oncol 2:220, 1983.

    Google Scholar 

  5. Fisher RI, DeVita VT, Hubbard SM, et al.: Randomized trial of ProMACE-MOPP vs. ProMACE-CytaBOM in previously untreated, advanced diffuse aggressive lymphomas. Proc Am Soc Clin Oncol 3:242, 1984.

    Google Scholar 

  6. Dana BW, Dahlberg S, Miller TP, et al.: mBACOD treatment for intermediate and high grade malignant lymphomas: a Southwest Oncology Group Phase II trial. J Clin Oncol 8:1155–1162, 1990.

    PubMed  CAS  Google Scholar 

  7. Miller TP, Dahlberg S, Fisher RI, et al.: Unfavorable histologies of non-Hodgkin’s lymphoma treated with ProMACE-CytaBOM: a groupwide Southwest Oncology Group study. J Clin Oncol 8:1951–1958, 1990.

    PubMed  CAS  Google Scholar 

  8. Weick JK, Dahlberg S, Fisher RI, et al.: Combination chemotherapy of intermediate and high grade non-Hodgkin’s lymphoma with MACOP-B: a Southwest Oncology Group study. J Clin Oncol 9:748–753, 1991.

    PubMed  CAS  Google Scholar 

  9. Longo DL, DeVita VT, Duffey PL, et al.: Superiority of ProMACE-CytaBOM over ProMACE-MOPP in the treatment of advanced diffuse aggressive lymphoma: results of a prospective randomized trial. J Clin Oncol 9:25–38, 1991.

    PubMed  CAS  Google Scholar 

  10. McKelvey EM, Gottlieb JA, Wilson HE, et al.: Hydroxyldaunomycin (adriamycin) combination chemotherapy in malignant lymphoma. Cancer 38:1484–1493, 1976.

    Article  PubMed  CAS  Google Scholar 

  11. Jones SE, Grozea PN, Metz EN, et al.: Improved complete remission rates and survival for patients with large cell lymphoma treated with chemoimmunotherapy. Cancer 51: 1083–1090, 1983.

    Article  PubMed  CAS  Google Scholar 

  12. Jones SE, Grozea PN, Miller TP, et al.: Chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone alone or with levamisole or with levamisole plus BCG for malignant lymphoma: a Southwest Oncology Group study. J Clin Oncol 3:1318–1324, 1985.

    PubMed  CAS  Google Scholar 

  13. Kaminiski MS, Coleman NC, Colby TV et al.: Factors predicting survival in adults with stage I and II large-cell lymphoma treated with primary radiation therapy. Ann Intern Med 104:747–756, 1986.

    Google Scholar 

  14. Armitage JO, Wen BC: Chemotherapy in patients who fail radiotherapy for diffuse aggressive non-Hodgkin’s lymphomas. Int J Radiat Oncol Biol Phys 13:1351–1354, 1987.

    Article  PubMed  CAS  Google Scholar 

  15. Miller TP, Grogan TM, Dalton WS, et al.: P-glycoprotein expression in malignant lymphoma and reversal of clinical drug resistance with chemotherapy plus high-dose verapamil. J Clin Oncol 9:17–24, 1991.

    PubMed  CAS  Google Scholar 

  16. Fisher RI, DeVita VT, Johnson BL, et al.: Prognostic factors for advanced diffuse histiocytic lymphoma following treatment with combination chemotherapy. Am J Med 63:177–182, 1977.

    Article  PubMed  CAS  Google Scholar 

  17. Jones SE, Miller TP, Connors JM: Long-term follow up and analysis for prognostic factors for patients with limited-stage diffuse large-cell lymphoma treated with initial chemotherapy with or without adjuvant radiotherapy. J Clin Oncol 7:1186–1191, 1989.

    PubMed  CAS  Google Scholar 

  18. Dixon DO, Neilan B, Jones SE, et al.: Effect of age on therapeutic outcome in advanced diffuse histiocytic lymphoma: the Southwest Oncology Group experience. J Clin Oncol 4:295–305, 1986.

    PubMed  CAS  Google Scholar 

  19. Fisher RI, Gaynor E, Dahlberg S, et al.: A phase III comparison of CHOP versus m-BACOD versus ProMACE-CytaBOM versus MACOP-B in patients with intermediate or high-grade non-Hodgkin’s lymphoma: preliminary results of SWOG-8516 (Intergrouop 0067), the National High Priority Lymphoma Study. Proc Am Soc Clin Oncol 11:1992.

    Google Scholar 

  20. Hryniuk W, Bush H: The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol 2:1281–1288, 1984.

    PubMed  CAS  Google Scholar 

  21. Hryniuk W: The importance of dose intensity in outcome of chemotherapy. In S Hellman, V DeVita, S Rosenberg S, eds. Important Advances in Oncology. Philadelphia: JB Lippincott, 1988, pp 121–141.

    Google Scholar 

  22. Dahlberg S, Miller TP, Dana B, et al.: Dose intensity is not associated with subsequent survival after adjustment for known prognostic factors in non-Hodgkin’s lymphoma patients treated with m-BACOD, ProMACE-CytaBOM, and MACOP-B on Southwest Oncology Group studies. Proc Am Soc Clin Oncol 9:255, 1990.

    Google Scholar 

  23. Anderson JR, Santarelli MT, Peterson G: Dose intensity in the treatment of diffuse large-cell lymphoma. J Clin Oncol 8:1927, 1990.

    PubMed  CAS  Google Scholar 

  24. Hryniuk W: Randomized trial of escalated versus standard BACOP (Bleomycin-Adriamycin-Cyclophosphamide-Oncovin-Prednisone) for intermediate grade lymphoma. Proc Am Soc Clin Oncol 10:272, 1991.

    Google Scholar 

  25. Dalton WS, Miller TP: Multidrug resistance. Principles and Practice of Oncology Updates III 5:1–13, 1991.

    Google Scholar 

  26. Salmon SE, Dalton WS, Grogan TM, et al.: Multidrug-resistant myeloma: laboratory and clinical effects of verapamil as a chemosensitizer. Blood 78:44–50, 1991.

    PubMed  CAS  Google Scholar 

  27. Miller TP, Grogan TM, Dalton WS, et al.: P-glycoprotein expression in malignant lymphoma and reversal of clinical drug resistance with chemotherapy plus high dose verapamil. J Clin Oncol 9:17–24, 1991.

    PubMed  CAS  Google Scholar 

  28. Lehnert M, Dalton WS, Roe D, et al.: Synergistic inhibition by verapamil and quinine of p-glycoprotein-mediated multidrug resistance in a human myeloma cell line model. Blood 77:348–354, 1991.

    PubMed  CAS  Google Scholar 

  29. Dalton WS: Reversing multidrug resistance in the laboratory and clinic. Proc Am Assoc Cancer Res 31:520–521, 1990.

    Google Scholar 

  30. Miller TP, Dahlberg S, Grogan TM, et al.: The proliferative rate of aggressive non-Hodgkin’s lymphomas identifies a patient group with fatal disease: a prospective Southwest Oncology Group trial. Proc Am Soc Clin Oncol 11:19921992.

    Google Scholar 

  31. Grogan TM, Lippman SM, Spier CM, et al.: Independent prognostic significance of a nuclear proliferation antigen in diffuse large cell lymphomas as determined by the monoclonal antibody Ki-67. Blood 71:1157–1160, 1988.

    PubMed  CAS  Google Scholar 

  32. Grogan TM, Miller TP: New biologic markers in non-Hodgkin’s lymphomas. Hematology Oncology Clinics of North America 5:925–933, 1991.

    CAS  Google Scholar 

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© 1993 Springer Science+Business Media New York

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Miller, T.P., Dahlberg, S. (1993). Treatment of diffuse large-cell lymphoma: A summary of outcome for patients treated by the Southwest Oncology Group. In: Dana, B.W. (eds) Malignant lymphomas, including Hodgkin’s disease: Diagnosis, management, and special problems. Cancer Treatment and Research, vol 66. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3084-8_4

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  • DOI: https://doi.org/10.1007/978-1-4615-3084-8_4

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4613-6347-7

  • Online ISBN: 978-1-4615-3084-8

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