Skip to main content
SpringerLink
Log in

The present status of therapy for patients with aggressive non-Hodgkin’s lymphoma

  • Chapter
Annals of Oncology

Summary

The aggressive non-Hodgkin’s lymphomas include some of the malignancies most frequently cured with chemotherapy. However, not all patients are cured, and the best treatment approach remains uncertain. The most common aggressive non-Hodgkin’s lymphomas are diffuse large-cell lymphoma and immunoblastic lymphoma. Most recent studies suggest no useful difference between these two groups. When these lymphomas are localized at presentation they are highly curable. Earlier studies showed that radiotherapy alone had a high relapse rate. Chemotherapy alone has been found to have an excellent cure rate, but when followed by radiotherapy, the amount of chemotherapy can be reduced with the same good result. A number of chemotherapy regimens have been shown to cure approximately 50% of patients with disseminated large-cell lymphoma. It appears that a number of regimens including m-BACOD, MACOP-B, LNH-84, ProMACE-CytaBOM, CAP-BOP, COP-BLAM, F-MACHOP, and perhaps full-dose CHOP achieve similar results when prognostic factors are taken into account. Currently the most important area for therapeutic research (unless new drugs are found) is in identifying those patients likely to be cured with our present treatments and those patients for whom alternative therapies such as bone marrow transplantation need to be considered as part of the primary treatment. This is true not only for large-cell lymphoma but also for the less common aggressive non-Hodgkin’s lymphomas such as lymphoblastic lymphoma, small noncleaved-cell lymphoma, and peripheral T-cell lymphoma.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 16.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. DeVita VT, Chabner B, Hubbard SP et al. Advanced diffuse histiocytic lymphoma, a potentially curable disease. Lancet 1973; 1: 248–250.

    Google Scholar 

  2. McKelvey EM, Gottlieb JA, Wilson HE et al. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer 1976; 38: 1484L1493.

    Google Scholar 

  3. Skarin AT, Rosenthal DS, Maloney WC et al. Combination chemotherapy of advanced non-Hodgkin’s lymphoma with bleomycin, Adriamycin, cyclophosphamide, vincristine, and prednisone (BACOP). Blood 1977; 49: 759–770.

    PubMed  CAS  Google Scholar 

  4. Longo DL, DeVita Jr, Duffey P et al. Randomized trial of ProMACE-MOPP v. ProMACE-CytaBOM in Stage II-IV aggressive non-Hodgkin’s lymphoma. Proc Am Soc Clin Oncol 1987; 6: 206.

    Google Scholar 

  5. Klimo P, Connors JM. Updated clinical experience with MACOP-B. Semin Hematol 1987; 24: 26–34.

    PubMed  CAS  Google Scholar 

  6. Coiffier B, Bryon PA, Berger F et al. Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80). J Clin Oncol 1986; 4: 147–153.

    PubMed  CAS  Google Scholar 

  7. Boyd DB, Coleman M, Papish SW et al. COPBLAM III: Infusional combination chemotherapy for diffuse large-cell lymphoma. J Clin Oncol 1988; 6: 425–433.

    PubMed  CAS  Google Scholar 

  8. Rappaport H. Tumors of the hematopoietic system in Atlas of Tumor Pathology, section 3, Fasicle 8, Washington DC, UA Armed Forces Institute of Pathology, 1966.

    Google Scholar 

  9. Lennert K, Mohri N, Stein H et al. The histopathology of malignant lymphoma. Br J Haematol 1975; 31: 193–203.

    Article  Google Scholar 

  10. Lukes RI, Collins RD. Immunologic characterization of human malignant lymphomas. Cancer 1974; 34: 1488–1503.

    Article  PubMed  Google Scholar 

  11. National Cancer Institute sponsored study of classification of non-Hodgkin’s lymphomas. Summary and description of a Working Formulation for clinical usage. The non-Hodgkin’s lymphoma Pathologic classification Project. Cancer 1982; 49: 2112–2135.

    Article  Google Scholar 

  12. NCI Non-Hodgkin’s Classification Project Writing Committee. Classification of non-Hodgkin’s lymphomas. Reproducibility of major classification systes. Cancer 1985; 55: 91–95.

    Article  Google Scholar 

  13. Levitt SH, Lee CR, Bloomfield CP et al. The role of radiation therapy in the treatment of early stage large cell lymphoma. Hematol Oncol 1985; 3: 33–37.

    Article  PubMed  CAS  Google Scholar 

  14. Vokes EE, Ultman JE, Golomb HM et al. Long-term survival of patients with localized diffuse histiocytic lymphoma. J Clin Oncol 1985; 3: 1309–1317.

    PubMed  CAS  Google Scholar 

  15. Nisson NI, Ersboll J, Hansen HS et al. A randomized study of radiotherapy versus radiotherapy plus chemotherapy in Stage I-II non-Hodgkin’s lymphomas. Cancer 1983; 52: 1–8.

    Article  Google Scholar 

  16. Carde P, Burgers IMV, van Glabbekem M et al. Combined radiotherapy-chemotherapy for early stage non-Hodgkin’s lymphoma. Radiotherapy Oncology 1984; 2: 301–304.

    Article  PubMed  CAS  Google Scholar 

  17. Miller TP, Jones SE. Initial chemotherapy for clinically localized lymphoma of unfavorable histology. Blood 1983; 62: 413–418.

    PubMed  CAS  Google Scholar 

  18. Connors JM, Klimo P, Fairey RN et al. Brief chemotherapy and involved field radiation therapy for limited stage, histologically aggressive lymphoma. Ann Intern Med 1987; 107: 25–30.

    Article  PubMed  CAS  Google Scholar 

  19. Jagannath S, Valasquez WS, Tucker SL et al. Stage IV diffuse large cell lymphoma: a long-term analysis. J Clin Oncol 1985; 3: 39–45.

    PubMed  CAS  Google Scholar 

  20. Dixon DO, Neilan B, Jones JE et al. Effect of ages on therapeutic outcome in advanced diffuse histiocytic lymphoma: The Southwest Oncology Group experience. J Clin Oncol 1986; 4: 295–305.

    PubMed  CAS  Google Scholar 

  21. Tirelli U, Zagonel V, Serraino J et al. Non-Hodgkin lymphomas in 137 patients ages 70 or older: A Retrospective European Organization for Research and Treatment of Cancer Lymphoma Group Study. J Clin Oncol 1988; 6: 1708–1713.

    PubMed  CAS  Google Scholar 

  22. Vose JM, Armitage JO, Weisenburger DD et al. The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin’s lymphoma. J Clin Oncol 1988; 6: 1838–1844.

    PubMed  CAS  Google Scholar 

  23. Ross RK, Dworsky RL, Paganini-Hill A et al. Non-Hodgkin’s lymphoma in never married men in Los Angeles. Br J Cancer 1985; 52: 785–787.

    Article  PubMed  CAS  Google Scholar 

  24. Levine AM, Gill PS. AIDS related malignant lymphoma: Clinical presentation and treatment approaches. Oncology 1987; 1: 41–46.

    PubMed  CAS  Google Scholar 

  25. Gill PS, Levine AM, Kraib M et al. AIDS-related malignant lymphoma: results of progressive treatment trials. J Clin Oncol 1987; 5: 1322–1328.

    PubMed  CAS  Google Scholar 

  26. Knowles DM, Chamulak GA, Subar M et al. Lymphoid neoplasia associated with the acquired immunodeficiency syndrome (AIDS). Ann Intern Med 1988; 108: 744–753.

    Article  PubMed  CAS  Google Scholar 

  27. Barmudez MA, Grant KM, Rodvien R et al. Non-Hodgkin’s lymphoma in a population with or at risk for acquired immunodeficiency syndrome: Indications for intensive chemotherapy. Am J Med 1989; 86: 71–76.

    Article  Google Scholar 

  28. So YT, Beckstead JHY, Davis PL. Primary central nervous system lymphoma in acquired immunodeficiency syndrome: A clinical and pathological study. Ann Neurol 1986; 20: 566–572.

    Article  PubMed  CAS  Google Scholar 

  29. Barcos MP, Lukes RJ. Malignant lymnphoma of convoluted lymphocytes - A new entity of possible T-cell type. In: Sinus LF, Godden JO (eds). Conflicts in childhood cancer. An evaluation of current management, Vol. 4, New York Liss, p 147, 1975.

    Google Scholar 

  30. Nathwani BN, Kim H, Rappaport H. Malignant lymphoma, lymphoblastic. Cancer 1976; 38: 964–983.

    Article  PubMed  CAS  Google Scholar 

  31. Levine AM, Forman SJ, Meyer PR et al. Successful therapy of convoluted T-lymphoblastic lymphoma in adults. Blood 1983; 61: 92–98.

    PubMed  CAS  Google Scholar 

  32. Wollner N, Wachtel AE, Exelby PR et al. Improved prognosis in children with intra-abdominal non-Hodgkin’s lymphoma following LSA2–L2 protocol chemotherapy. Cancer 1980; 45: 3034–3039.

    Article  PubMed  CAS  Google Scholar 

  33. Bernstein JI, Coleman N, Strickelr JG et al. Combined modality therapy for adults with small non-cleaved cell lymphoma (Burkitt’s and non-Burkitt’s type). J Clin Oncol 1986; 4: 847–858.

    PubMed  CAS  Google Scholar 

  34. Horning SJ, Weiss CL, Crabtree CG et al. Clinical and phenotypic diversity of T-cell lymphomas. Blood 1986; 67: 1578–1582.

    Google Scholar 

  35. Simoyama M, Ota K, Kikuchi M et al. Major prognostic factors of adult patients with advanced T-cell lymphoma/leukemia. J Clin Oncol 1988; 6: 1088–1097.

    Google Scholar 

  36. Coiffier B, Berger F, Byron P-A et al. T-cell lymphomas; Immunologic, histologic, clinical and therapeutic analysis of 63 cases. J Clin Oncol 1988; 6: 1584–1589.

    PubMed  CAS  Google Scholar 

  37. Armitage JO, Vose JM, Linder J et al. Clinical significance of immunophenotype in diffuse aggressive non-Hodgkin’s lymphoma. J Clin Oncol 1989; 7: 1783–1790.

    PubMed  CAS  Google Scholar 

  38. McKelveny EM, Gottlieb JA, Wilson HE et al. Hydroxyldaunomycin (Adriamycin) combiantion chemotherapy in malignant lymphoma. Cancer 1976; 38: 1484–1493.

    Article  Google Scholar 

  39. Coltman CA, Jr., Dahlberg S, Jones SE et al. CHOP is curative in thirty percent of patients with large cell lymphoma: A twelve-year Southwest Oncology Group follow-up. Proc Am Soc Clin Oncol 1986 (abstr); 5: 197.

    Google Scholar 

  40. Fisher RI, DeVita VT, Johnson BL et al. Prognostic factors for advanced diffuse histiocytic lymphoma following treatment with combination chemotherapy. Am J Med 1977; 63: 177–182.

    Article  PubMed  CAS  Google Scholar 

  41. Dixon DO, Neilan B, Jones JE et al. Effect of age on therapeutic outcome in advanced diffuse histiocytic lymphoma: The Southwest Oncology Group experience. J Clin Oncol 1986; 4: 295–305.

    PubMed  CAS  Google Scholar 

  42. Todd MB, Portlock CS, Farber LR et al. Prognostic indicators in diffuse large-cell histiocytic lymphoma. Int J Radiat Oncol Biol Phys 1986; 12: 593–601.

    Article  PubMed  CAS  Google Scholar 

  43. Armitage JO, Dick FR, Corder MP et al. Predicting therapeutic outcome in patients with diffuse histiocytic lymphoma treated with cyclophosphamide, Adriamycin, vincristine, and prednisone (CHOP). Cancer 1982; 50: 1695–1702.

    Article  PubMed  CAS  Google Scholar 

  44. Jagannath S, Valasquez WS, Tucker SL et al. Tumor burden assessment and its implication for a prognostic model in advanced diffuse large cell lymphoma. J Clin Oncol 1986; 4: 859–865.

    PubMed  CAS  Google Scholar 

  45. Skarin AT, Conellos GP, Rosenthal DS et al. Improved prognosis of diffuse histiocytic and undifferentiated lymphoma by use of high-dose methotrexate alternating with standard agents (M-BACOD). J Clin Oncol 1983; 1: 91–98.

    PubMed  CAS  Google Scholar 

  46. Canellos GP, Skarin AT, Klatt MM et al. The m-BACOD combination chemotherapy regimen in the treatment of diffuse large-cell lymphoma. Semin Hematol 1987; 24: 2–7.

    PubMed  CAS  Google Scholar 

  47. Klimo P, Connors JM. MACOP-B chemotherapy for the treatment of advanced diffuse large-cell lymphoma. Ann Intern Med 1985; 102: 596–602.

    Article  PubMed  CAS  Google Scholar 

  48. Gordon LI, Harrington D, Glick JH et al. Randomized Phase IH comparison of CHOP versus m-BACOD in diffuse large cell and diffuse mixed lymphoma: Equivalent complete remission and time to treatment failure but greater toxicity with m-BACOD. Proc Am Soc Clin Oncol 1989 (Abstr); 8: 255.

    Google Scholar 

  49. Miller TP, Dana BW, Weick JK et al. Southwest Oncology Group Clinical trials for intermediate and high-grade non-Hodgkin’s lymphoma. Semin. Hematol 1988; 25: 17–22.

    PubMed  CAS  Google Scholar 

  50. Goldie JH, Coldman AJ, Gudauskas GA. Rationale for the use of alternating non-cross resistant chemotherapy. Cancer Treat Rep 1982; 66: 439–449.

    PubMed  CAS  Google Scholar 

  51. Longo D, DeVita VT Jr, Duffey P et al. Randomized trial of ProMACE-MOPP (Day 1, D8) PM vs. ProMACE-CytaBOM (PC) in Stage II-IV aggressive Non-Hodgkin’s lymphoma. Proc Am Soc Clin Oncol 1987 (Abstr); 6: 206.

    Google Scholar 

  52. Browne MJ, Hubbard SM, Longo DL et al. Excess prevalence of pneumocytis carinii pneumonia in patients treated for lymphoma with combination chemotherapy. Ann Intern Med 1986; 104: 338–344.

    Article  PubMed  CAS  Google Scholar 

  53. Coiffier B, Bryon PA, French M et al. Intensive chemotherapy in aggressive lymphomas: Updated results of LNH-80 Protocol and Prognostic Factors affecting response and survival. Blood 1987; 70: 1394–1399.

    PubMed  CAS  Google Scholar 

  54. Cabanillas F, Hagemeister FB, McLaughlin P et al. Results of MIME regimen for recurrent or refractory lymphoma. J Clin Oncol 1987; 5: 407–412.

    PubMed  CAS  Google Scholar 

  55. Hagberg H, Cavallin-Stahl E, Lind J. Ifosfamide and etoposide as salvage therapy for non-Hodgkin’s lymphoma. Scand J Haematol 1986; 36: 61–64.

    PubMed  CAS  Google Scholar 

  56. Velasquez WS, Cabanillas F, Salvador P et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood 1988–71: 117–122.

    Google Scholar 

  57. O’Donnell MR, Forman SJ, Levine AM et al. Cytarabine, cisplatin and etoposide chemotherapy for refractory non-Hodgkin’s lymphoma. Cancer Treat Rep 1987; 71: 187–189.

    PubMed  Google Scholar 

  58. Warrell RP, Coonley CJ, Straus DJ et al. Treatment of patients with advanced malignant lymphoma using gallium nitrate administered as a sevenday continuous infusion. Cancer 1983; 51: 1982–1987.

    Article  PubMed  Google Scholar 

  59. Helms SR, Oblon DJ, Braylan RC et al. Etoposide, carmustine, bleomycin and methotrexate with leucovorin rescue as retreat-ment for unfavorable non-Hodgkin’s lymphoma. Cancer Treat Rep 1985; 69: 783–786.

    PubMed  CAS  Google Scholar 

  60. Philip T, Armitage JO, Spitzer G et al. High-dose therapy and autologous bone marrow transplantation after failure of conventional chemotherapy in adults with intermediate-grade or high-grade non-Hodgkin’s lymphoma. N Engl J Med 1987; 316: 1493–1498.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Nebraska Medical Center, Omaha, Nebraska, USA

    Dr. Julie M. Vose & James O. Armitage

Authors
  1. Dr. Julie M. Vose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. James O. Armitage
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Section of Hematology/Oncology, Department of Medicine, The University of Chicago Cancer Research Center, Chicago, Illinois, USA

    John E. Ultmann  & Brian L. Samuels  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1991 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Vose, J.M., Armitage, J.O. (1991). The present status of therapy for patients with aggressive non-Hodgkin’s lymphoma. In: Ultmann, J.E., Samuels, B.L. (eds) Annals of Oncology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-7305-4_27

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-7305-4_27

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-7294-1

  • Online ISBN: 978-1-4899-7305-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation