THE CYCLOPHOSPHAMIDE, VINCRISTINE, PREDNISONE, BLEOMYCIN, DOXORUBICIN, AND PROCARBAZINE (COPPBLAM-I) REGIMEN FOR INTERMEDIATE-GRADE NON-HODGKINS-LYMPHOMA - LONG-TERM FOLLOW-UP IN 51 PATIENTS

Background. Cyclophosphamide, vincristine, prednisone, bleomycin, doxorubicin, and procarbazine (COP-BLAM-I) is a second generation combination chemotherapy for intermediate-grade non-Hodgkin's lymphoma (NHL). Since the first report by Laurence et al. in 1982, only a few series were reported on the long term results of this regimen. Methods. In this prospective study, the clinical courses of 51 patients with intermediate-grade NHL (F, G, or H according to the International Working Formulation grading criteria) with a median age of 65 years (range, 55-81), who were diagnosed between 1983 and 1992, are reported. Eligibility criteria included at least one full cycle of the regimen and no previous chemotherapy. Results. A mean of seven cycles (range, two to nine) with two escalations (range, zero to six) was administered. In a median follow-up of 2.4 years (range, 0.5-10), 33 patients (65%) experienced complete remission. The projected 3-year overall survival (OS) and progression free survival rates (PFS) were 58% and 77%, respectively, and the projected 5-year OS and PFS were 52% and 72%, respectively. In only 2 patients (4%) were treatment-related deaths observed, whereas nonfatal complications were more common. Patients in the low risk group, according to the international NHL prognostic index, had the best outcome. The mean percentage of projected dose intensity (DI) was 95% (range, 77-109), whereas no difference in DI was found between patients younger or older than 65 years. Conclusions. In a single center, COPBLAM-I combination chemotherapy was safe and effective for patients older than 55 years with intermediate-grade NHL.