MACOP-B regimen in non-Hodgkin's lymphoma

Two university centers in Finland used MACOP-B regimen as first-line treatment of intermediate and high-grade non-Hodgkin's lymphomas in 1986-1990. The clinical records of all 41 patients treated with this regimen were analyzed. The median age was 47 years (range 16-65), 24% of the patients had WHO performance status > 1, 49% had B-symptoms, 46% had Ann Arbor stage III or IV disease, and 39% had bulky disease. Twenty-three (58%) of the 40 patients who were evaluable for response had CR. The survival rate 36 months after the start of MACOP-B was 62%, but failure-free survival rate only 36%. Among several analyzed factors a lactate dehydrogenase level < 500 U/l before treatment showed the strongest association to failure-free survival. The planned dose intensity was not achieved mainly because of toxicity, and the ratio of the actual dose intensity given to the planned dose intensity varied for the different drugs between 0.77 and 0.92.