Chemotherapy of non-Hodgkin's lymphomas: Eastern Cooperative Oncology Group experience

The addition of prednisone to the two-drug combination of cyclophosphamide and vincristine increases the number of complete remissions (CR). Patients who had CRs in at least two of the studies, EST 0168 and EST 3472, lived significantly longer than those who had partial remissions. In EST 0168, the survival time correlated strongly with the nodal pattern and cell type, confirming results of Rosenberg and co-workers. EST 1472 confirmed the activity of BCNU in lymphocytic lymphomas; when both agents are combined with prednisone, the induction potential of BCNU is equal to that of cyclophosphamide. In the histiocytic lymphomas, BCNU added to CVP increases the percentage of CRs but it does so at the expense of considerable toxicity. EST 0871 demonstrated that low-dose bleomycin and hexamethylmelamine are active agents in lymphoma and should be combined with other effective combinations in an attempt to improve the CR rate. Finally, our current studies demonstrate that the failure rate in the diffuse or unfavorable lymphomas is higher than that in the more favorable nodular forms.