[Alternating CHOP-MEVP chemotherapy for advanced-stage, intermediate- and high-grade non-Hodgkin's lymphomas]

Twenty-one patients with advanced-stage, intermediate- and high-grade non-Hodgkin's lymphomas were treated with alternating CHOP-MEVP chemotherapy. CHOP therapy consisted of CPA 650 mg/m2, ADM 45 mg/m2, VCR 1.4 mg/m2 and Pred 40 mg/m2 (po). MEVP therapy consisted of MIT 10 mg/m2 (iv) VDS 2 mg/m2 (iv) on day 1, etoposide 200 mg/m2 (po) on days 1-3, and Pred 40 mg/m2 (po) on days 1-5. Three courses of CHOP therapy and MEVP therapy were alternatively administered every three weeks. CR was achieved in 15 (71.4%) of 21 patients. Survival rate and relapse-free rate at 2 years for all 21 patients were 61.9% and 30.9%, respectively. Toxicity was generally tolerable except for CMV interstitial pneumonitis in a patient with IBL-like T-cell lymphoma and secondary leukemia in a patient with T-cell lymphoma. Chemotherapy of higher dose intensity is required to improve the relapse-free survival rate in these subsets of lymphoma.