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CHOP versus MACOP-B in aggressive lymphoma--a Nordic Lymphoma Group randomised trial

Jerkeman, Mats LU ; Anderson, Harald LU ; Cavallin-Ståhl, Eva LU ; Dictor, Michael LU ; Hagberg, H; Johnson, A; Kaasa, S; Kvaloy, S; Sundstrom, C and Åkerman, Måns LU (1999) In Annals of Oncology 10(9). p.1079-1086
Abstract
BACKGROUND: The long-term survival of patients with advanced stage aggressive lymphoma has not improved significantly during the last twenty years. In a randomised trial, the efficacy of MACOP-B, a six-drug weekly chemotherapy regimen, was compared to CHOP, the current standard regimen, in terms of overall and failure-free survival, toxicity and health related quality of life. PATIENTS AND METHODS: Four hundred five patients with aggressive lymphoma, stage II-IV, age 18-67, were randomised to receive either 12 weeks of MACOP-B or 8 courses of CHOP over 24 weeks. Special emphasis was put in the definition of Ann Arbor stage in extranodal disease. A subset of 95 patients also entered a quality of life study, based on the EORTC QLQ-C30.... (More)
BACKGROUND: The long-term survival of patients with advanced stage aggressive lymphoma has not improved significantly during the last twenty years. In a randomised trial, the efficacy of MACOP-B, a six-drug weekly chemotherapy regimen, was compared to CHOP, the current standard regimen, in terms of overall and failure-free survival, toxicity and health related quality of life. PATIENTS AND METHODS: Four hundred five patients with aggressive lymphoma, stage II-IV, age 18-67, were randomised to receive either 12 weeks of MACOP-B or 8 courses of CHOP over 24 weeks. Special emphasis was put in the definition of Ann Arbor stage in extranodal disease. A subset of 95 patients also entered a quality of life study, based on the EORTC QLQ-C30. RESULTS: Thirty-one patients were ineligible. Among the remaining 374 patients, the median age was 52 years. According to the age-adjusted International Prognostic Index, 37% were 'high-intermediate' or 'high-risk' patients. No difference could be demonstrated, either in overall survival (60% at five years in the MACOP-B group and 59% in the CHOP group) or in failure-free survival (47% at five years with MACOP-B and 44% with CHOP). In terms of quality of life, physical function and global quality of life were more impaired in patients receiving MACOP-B, who also exhibited more non-haematological toxicity. CONCLUSION: No superiority of MACOP-B compared to CHOP could be demonstrated. CHOP remains the treatment of choice in low-risk patients. At present, intensified or experimental treatment should be reserved for high-risk disease. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
prognostic factors, aggressive lymphoma, chemotherapy, randomised trial
in
Annals of Oncology
volume
10
issue
9
pages
1079 - 1086
publisher
Oxford University Press
external identifiers
  • pmid:10572606
  • scopus:0032870340
ISSN
1569-8041
DOI
10.1023/A:1008392528248
language
English
LU publication?
yes
id
d21875f3-7128-4db4-a648-708b2b48fdc6 (old id 1116056)
date added to LUP
2008-07-09 14:38:08
date last changed
2017-01-01 07:07:40
@article{d21875f3-7128-4db4-a648-708b2b48fdc6,
  abstract     = {BACKGROUND: The long-term survival of patients with advanced stage aggressive lymphoma has not improved significantly during the last twenty years. In a randomised trial, the efficacy of MACOP-B, a six-drug weekly chemotherapy regimen, was compared to CHOP, the current standard regimen, in terms of overall and failure-free survival, toxicity and health related quality of life. PATIENTS AND METHODS: Four hundred five patients with aggressive lymphoma, stage II-IV, age 18-67, were randomised to receive either 12 weeks of MACOP-B or 8 courses of CHOP over 24 weeks. Special emphasis was put in the definition of Ann Arbor stage in extranodal disease. A subset of 95 patients also entered a quality of life study, based on the EORTC QLQ-C30. RESULTS: Thirty-one patients were ineligible. Among the remaining 374 patients, the median age was 52 years. According to the age-adjusted International Prognostic Index, 37% were 'high-intermediate' or 'high-risk' patients. No difference could be demonstrated, either in overall survival (60% at five years in the MACOP-B group and 59% in the CHOP group) or in failure-free survival (47% at five years with MACOP-B and 44% with CHOP). In terms of quality of life, physical function and global quality of life were more impaired in patients receiving MACOP-B, who also exhibited more non-haematological toxicity. CONCLUSION: No superiority of MACOP-B compared to CHOP could be demonstrated. CHOP remains the treatment of choice in low-risk patients. At present, intensified or experimental treatment should be reserved for high-risk disease.},
  author       = {Jerkeman, Mats and Anderson, Harald and Cavallin-Ståhl, Eva and Dictor, Michael and Hagberg, H and Johnson, A and Kaasa, S and Kvaloy, S and Sundstrom, C and Åkerman, Måns},
  issn         = {1569-8041},
  keyword      = {prognostic factors,aggressive lymphoma,chemotherapy,randomised trial},
  language     = {eng},
  number       = {9},
  pages        = {1079--1086},
  publisher    = {Oxford University Press},
  series       = {Annals of Oncology},
  title        = {CHOP versus MACOP-B in aggressive lymphoma--a Nordic Lymphoma Group randomised trial},
  url          = {http://dx.doi.org/10.1023/A:1008392528248},
  volume       = {10},
  year         = {1999},
}