NOPE for relapsed aggressive diffuse non-Hodgkin's lymphoma

Forty three patients with relapsed, diffuse aggressive lymphoma (Working Formulation Categories G to J) were treated with a combination chemotherapy regimen consisting of mitoxantrone 10 mg/m2 iv day 1, vincristine 1.4 mg/m2 iv day 1 and 14, prednisolone 50 mg/m2 p.o. days 1-5 and etoposide 100 mg/m2 p.o. days 1-5 of each cycle (NOPE). Fourteen patients (34%) achieved complete remission and another 6/43 (15%) achieved a partial response. Factors which significantly affected response were the presence of early stage, absence of systemic symptoms, non-bulky disease and serum LDH value < 350 IU. Four patients are alive and in complete remission from 25+ to 45+ months after completion of therapy. Duration of response and survival was significantly influenced by the duration of the initial response to first chemotherapy. NOPE is an active and safe treatment regimen with a substantial complete remission rate in patients with relapsed non-Hodgkin's lymphoma.