Dose-intensity analysis for CHOP chemotherapy in diffuse aggressive large cell lymphoma

Dose intensity may play an important role in the success of cancer chemotherapy. We have investigated the relationship between RDI of the combination of cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) and the results of therapy in a group of 78 newly diagnosed patients with diffuse histiocytic and diffuse mixed non-Hodgkin's lymphoma. The achievement of CR was associated with high DI. In the initial cycles needed to achieve a maximal response, a significantly greater proportion of complete responders received average RDI, RDI of CTX and RDI of adriamycin greater than 0.8, as compared with noncomplete responders: 52 vs. 23%, 62 vs. 34% and 61 vs. 29%, respectively (P less than 0.05). Sixty-one patients achieved CR. Among these, RDI of CTX was best and significantly correlated with survival: 81 and 54% 5-year actuarial survival of patients receiving greater than 0.7 and less than 0.7 RDI, respectively (P less than 0.05). Our data indicate that there is a clear dose-rate effect of CHOP, particularly of CTX, on the therapeutic outcome. High DI may improve results of treatment in patients with diffuse, large cell lymphoma.