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Five‐year results of the treatment of 23 patients with immunoproliferative small intestinal disease
Author(s) -
Akbulut Hakan,
Soykan Irfan,
Yakaryilmaz Fahri,
Icli Fikri,
Aksoy Fehmi,
Haznedaroglu Serap,
Yildirim Safa
Publication year - 1997
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19970701)80:1<8::aid-cncr2>3.0.co;2-t
Subject(s) - medicine , copp , regimen , procarbazine , vincristine , surgery , gastroenterology , chemotherapy , cyclophosphamide , stage (stratigraphy) , survival rate , heme , paleontology , biochemistry , chemistry , heme oxygenase , biology , enzyme
BACKGROUND Currently, there is no agreement regarding optimal treatment strategies for immunoproliferative small intestinal disease (IPSID). In this article, the authors report the treatment outcomes of a group of 23 Turkish patients with IPSID. METHODS Between December 1988 and July 1993, 23 consecutive patients with IPSID, including 5 with secretory type, were included in the study. Seven patients with Stage A disease (according to the criteria of Galien et al.) received tetracycline (1 g/day, orally) for a median duration of 7 months (range, 6‐11 months) initially, whereas the remaining patients (9 Stage B patients and 7 Stage C patients) received combination chemotherapy (cyclophosphamide, vincristine, procarbazine, and prednisolone [COPP regimen]) followed by tetracycline at a dose of 1 g/day for 6 more months in patients with complete response (CR) after the COPP regimen. RESULTS The median follow‐up was 68 months (range, 38‐89 months). As first‐line therapy in Stage A patients, tetracycline yielded a 71% CR and 43% disease free survival (DFS) rate. Eleven of 16 patients (69%) with Stage B or C disease who received the COPP regimen achieved CR and only 2 patients had a recurrence (DFS rate of 56%). The 5‐year overall survival (OAS) rate for the entire group was 70%, and the 5‐year DFS rate for patients with CR was 75%. However, the median OAS for 3 patients with immunoblastic lymphoma was only 7 months. CONCLUSIONS The COPP regimen, with its acceptable toxicity, appears to be a good alternative as a first‐line treatment for patients with Stage B or C IPSID with low grade lymphoma whereas tetracycline appears to be the initial treatment of choice for patients with Stage A disease. Cancer 1997; 80:8‐14. ©; 1997 American Cancer Society.