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.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
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.
Klimo P, Connors JM: MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma. Ann Intern Med 102:596–602, 1985.
Coleman, M: Chemotherapy for large-cell lymphoma: Optimism and caution. Ann Intern Med 103:140–142, 1985.
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.
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.
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.
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.
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.
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.
McKelvey EM, Gottlieb JA, Wilson HE, et al.: Hydroxyldaunomycin (adriamycin) combination chemotherapy in malignant lymphoma. Cancer 38:1484–1493, 1976.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Hryniuk W, Bush H: The importance of dose intensity in chemotherapy of metastatic breast cancer. J Clin Oncol 2:1281–1288, 1984.
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.
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.
Anderson JR, Santarelli MT, Peterson G: Dose intensity in the treatment of diffuse large-cell lymphoma. J Clin Oncol 8:1927, 1990.
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.
Dalton WS, Miller TP: Multidrug resistance. Principles and Practice of Oncology Updates III 5:1–13, 1991.
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.
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.
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.
Dalton WS: Reversing multidrug resistance in the laboratory and clinic. Proc Am Assoc Cancer Res 31:520–521, 1990.
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.
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.
Grogan TM, Miller TP: New biologic markers in non-Hodgkin’s lymphomas. Hematology Oncology Clinics of North America 5:925–933, 1991.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer Science+Business Media New York
About this chapter
Cite this chapter
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
Download citation
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
eBook Packages: Springer Book Archive