The F-MACHOP sequential combination chemotherapy regimen in advanced diffuse aggressive lymphomas: long-term results

The present study reports the long-term results of the F-MACHOP sequential combination chemotherapy regimen in 113 adult patients with advanced stages of diffuse large-cell or undifferentiated lymphoma who were consecutively treated with this regimen from January 1980 to December 1986 at a single institution. The CR rate was 78% and 17 relapses were observed, so that 80% of CR patients are expected to be free of relapse at 5 and 10 years after a median follow-up off-therapy of 5.7 years (range 3.2-10.1). Projected survival and event-free survival at 8 years are 68% and 62%, respectively. Prognostic factor analysis indicates that the CR rate was influenced by systemic symptoms and number of extranodal sites, disease-free survival by tumor burden and number of courses to achievement of CR, event-free survival and survival by tumor mass diameter, systemic symptoms and number of extranodal sites. Toxicity was mainly hematological, and 3 patients (3%) died while severely neutropenic. The rapidity of response appears to have prognostic value, particularly in patients presenting with high tumor burden, in whom achievement of a CR within 3 courses indicates a group of patients with a very high chance of cure with this regimen.