Effective treatment of small-noncleaved-cell lymphoma with high-intensity, brief-duration chemotherapy

Mary L. McMaster, John P. Greer, F. Anthony Greco, David H. Johnson, Steven N. Wolff, John D. Hainsworth

Research output: Contribution to journalArticle

78 Scopus citations

Abstract

Small-noncleaved-cell (SNC) lymphoma is a high-grade, biologically aggressive neoplasm notable for poor response to therapy, high relapse rate, and less than a 20% long-term survival. We treated 20 patients with SNC lymphoma with a novel chemotherapeutic regimen using intensive doses of chemotherapy at frequent intervals in the inpatient setting. All patients were previously untreated. Sixteen patients (80%) had stage IV disease. Most patients (95%) had at least one other characteristic associated with poor prognosis (bulky [> 10 cm] disease, multiple extranodal sites, poor performance status), and 85% had two or more characteristics associated with poor prognosis. Seventeen patients (85%) achieved a complete response (CR) to therapy, including all three patients with human immunodeficiency virus (HIV)-associated disease. There have been three relapses, all occurring less than 18 months after treatment, and two of three relapses occurred in patients who were unable to complete therapy. At a median follow-up of 29 months, 13 patients (65%) remain disease-free; the calculated 5-year actuarial disease-free survival is 60%. Toxicity, chiefly myelosuppression, was severe but manageable. There were two treatment-related deaths, both in elderly patients with poor performance status and advanced-stage disease. These data suggest that such a dose-intensive approach improves the response and survival of patients with SNC lymphoma.

Original languageEnglish (US)
Pages (from-to)941-946
Number of pages6
JournalJournal of Clinical Oncology
Volume9
Issue number6
DOIs
StatePublished - Jan 1 1991

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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