Prognostic factors for advanced diffuse histiocytic lymphoma following treatment with combination chemotherapy

Combination chemotherapy can dramatically improve the survival of those patients with advanced diffuse histiocytic lymphoma who enter complete remission. The age, sex, stage, constitutional symptoms, sites of disease and tumor mass of 56 consecutive patients with advanced diffuse histiocytic lymphoma were analyzed as prognostic factors. Twenty-four patients received cytoxan, vincristine, procarbazine and prednisone (C-MOPP) and 32 patients received bleomycin, adriamycin, cytoxan, vincristine and prednisone (BACOP). In 26 of 56 (46 per cent) a complete remission was achieved, in 21 of 56 (38 per cent) a partial remission and in nine of 56 (16 per cent) no response. Median survival with a complete remission was not reached at three years with 82 per cent still alive, but was significantly greater than with a partial remission (7.6 months median) or no response (3.2 months median). Survival of those with a partial remission and no response did not differ statistically. Stage IV disease, bone marrow involvement, gastrointestinal involvement and a tumor mass greater than 10 cm in diameter in a single location were all poor prognostic factors. No other analyzed factor significantly affected survival in this study. Complete response rates and survival curves for patients treated with C-MOPP were similar to those treated with BACOP.