[Non-Hodgkin's lymphomas. Results of alternating chemotherapy versus sequential chemotherapy]

An analysis is presented of the results attained in 115 cases of advanced non-Hodgkin's lymphoma (stages III and IV) with high or intermediate grade histology (with exception of lymphoblastic lymphoma) which had received no previous treatment. The patients were distributed at random into two groups, A and B. Patients in group A received the classical CHOP-Bleo regimen, and they were given six courses at three-week intervals. The patients of group B received alternate chemotherapy consisting of two CHOP-Bleo courses, two CMED (cyclophosphamide, methotrexate, etoposide, dexamethasone) courses, and two CHOP-Bleo courses. The complete remission rates were 68% for patients of group A and 70% for patients of group B (p = 0.81); the duration of complete remission was 36 and 45 months, respectively (p = 0.73). Nineteen cases in group A (34%) and 18 in group B (30%) relapsed. Disease-free survival at five years was 34% for group A and 40% for group B (p = 0.67). No differences were found in toxicity of chemotherapy between the two groups. It was concluded that the alternate chemotherapy regimen CHOP-Bleo/CMED shows similar effects than the classical CHOP-Bleo treatment, and provides a lesser amount of adriamycin, which makes it feasible to use this or other anthracycline drugs in case of relapse; the use of this regimen must be borne in mind when the patient is carrying a myocardiopathy.