Therapie der Non-Hodgkin-Lymphome (NHL) von hohem Malignitaetsgrad des Erwachsenenalters Schlussbericht

Abstract

With the aim to improve the induction polychemotherapy in stage II-IV (Ann Arbor classification) high grade malignant non-Hodgkin lymphoma, the sequential application of two regimens was evaluated (COP-BLAM/IMVP-16 protocol). According to the results of an early restaging evaluation, the switch to the second regimen was performed response-adapted after 3 (in case of partial remission) or 5 (in case of complete remission) cycles of COP-BLAM/IMVP-16. After completion of chemotherapy, patients in complete remission were randomized to receive additional radiotherapy or remain without further treatment. 593 patients were recruited in a multicenter trial, median observation time 55 months. The rate of complete remissions was 60% and the relapse-free and overall survival 57% and 52% after 4 years. There was no prognostic difference between patients randomized to radiotherapy and those followed without. Instead, detailed analyses of prognostic risk revealed that the long-term prognosis was predominantly influenced by the presence of crucial initial parameters. In younger patients with lymphoblastic lymphoma a multiphase regimen was evaluated and a 4-years survival of 44% was achieved. (orig.)SIGLEAvailable from TIB Hannover: F94B0422 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman