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Comparison of CHOP versus CIOP in good prognosis younger patients with histologically aggressive non‐Hodgkin lymphoma
Author(s) -
Burton C.,
Smith P.,
VaughanHudson G.,
Qian W.,
Hoskin P.,
Cunningham D.,
Hancock B.,
Linch D.
Publication year - 2005
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2005.05640.x
Subject(s) - vincristine , medicine , idarubicin , chop , anthracycline , prednisolone , gastroenterology , cyclophosphamide , lymphoma , chemotherapy , doxorubicin , regimen , surgery , cancer , cytarabine , breast cancer
Summary CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) has been the standard chemotherapy regimen used for diffuse large cell lymphomas for over 30 years. Idarubicin is a 4‐demethoxy‐anthracycline analogue of daunorubicin that has proven activity in non‐Hodgkin lymphoma, and has been reported to cause less cardiotoxicity. We therefore initiated a randomised trial of standard dose CHOP versus CIOP (cyclophosphamide, idarubicin, vincristine and prednisolone), in which doxorubicin 50 mg/m 2 was substituted by idarubicin 10 mg/m 2 , a dose thought to have equivalent anti‐lymphoma activity. This trial was closed prematurely after 211 patients had completed therapy when a lower complete remission (CR) rate was noted in the CIOP arm. The formal results with long‐term follow up are now reported. Overall response rate was 84% in the CHOP arm and 78% in the CIOP arm, CR rates were 70% and 52% respectively in all patients ( P = 0·013) and 73% and 52% respectively for the eligible patients ( P = 0·0084). At a median of 8 years follow‐up, 4‐year progression‐free survival for all patients was 56% in the CHOP arm and 40% in the CIOP arm ( P = 0·0096). Overall survival for all patients was 65% in the CHOP arm and 56% in the CIOP arm ( P = 0·14). Results for eligible patients were comparable. CIOP containing idarubicin at a dose of 10 mg/m 2 is clearly inferior to standard CHOP.