Advanced non-Hodgkins' lymphomas: response to treatment with combination chemotherapy and factors influencing prognosis

Response to combination chemotherapy with cyclophosphamide, vincristine and prednisone (COP) and specific factors influenceing prognosis were evaluated in 70 patients with stage III or IV non-Hodgkin's lymphomas. Complete remissions (CR) were observed in 40% of patients, with a total response rate of 88%. The median duration of CR was 8 months, but 50% of patients were in continuing CR. High rates of CR were associated with: (a) well-differentiated lymphocytic cytology, (b) tumour nodularity, (c) normal blood lymphocyte counts at diagnosis, and (d) disease stage IIIA. These same factors also showed a positive correlation with 5-year-survival rates from diagnosis. It is suggested that patients with advanced non-Hodgkin's lymphomas do not form a homogeneous treatment group, but warrant a differential therapeutic approach based on the prognostic determinants stated above. The study provides further support for the prognostic usefulness of Rappaport's classification of these tumours.