[Treatment with ACVP-16 for relapsed and refractory non-Hodgkin's lymphoma]

ACVP-16 chemotherapy combined with recombinant granulocyte-colony stimulating factor (rG-CSF) was carried out on patients with malignant lymphoma which were recurrent or resistant to chemotherapy including adriamycin. Twenty patients with non-Hodgkin's lymphoma, 11 men and 9 women, with a median age of 54 years, were entered in this study. Fourteen patients had diffuse large cell lymphoma, 4 diffuse medium, and 2 diffuse mixed. The previous treatments for these patients were COP-BLAM, IMV-triple P and COP-BLAM III. The ACVP-16 regimen included ara-C at 100 mg/m2 i.v. on day 1 to 5, CBDCA at 250 mg/m2 i.v. on day 1, and VP-16 at 70 mg/m2 i.v. on day 1 to 3. Subcutaneous administration of rG-CSF at 2 micrograms/kg was started on day 7. Since complete remission was achieved in 7 patients (35%) and partial remission in 8 (40%), the total response rate was 75%. The median survival duration after the initiation of this therapy was 11 months for those who achieved CR and 4 months for those who achieved PR and those who had no response. Leukopenia (< or = 1,000/microliters) and thrombocytopenia (< or = 50,000/microliters) were observed in 15 (75%) and 12 (60%), respectively. We conclude that the ACVP-16 regimen is useful for the treatment of refractory or relapsed non-Hodgkin's lymphoma. However, the patients who are treated with this regimen should be carefully managed in order to avoid severe infection, because leukopenia was observed even when rG-CSF was administered.