Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma

A phase II study of the Southwest Oncology Group (SWOG 9349)

Douglas W. Blayney, Michael L. LeBlanc, Thomas Grogan, Ellen R. Gaynor, Robert A. Chapman, C. Harris Spiridonidis, Sarah A. Taylor, Scott I. Bearman, Thomas P Miller, Richard I. Fisher

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Purpose: To test the hypothesis that therapy of intermediate- and high-grade (excluding Burkitt lymphoblastic) lymphoma with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) could be safely dose-intensified with routine filgrastim support. Patients and Methods: Eligible patients were those who were previously untreated and who had either bulky stage II, or stage III or IV lymphoma with working formulation histology D, E, F, G, H, or J; performance status ≤ 2; and acceptable end organ function. No upper age limit was specified. Therapy was dose-intensified CHOP (CHOP-DI) with filgrastim support. Each course was repeated every 14 days for six planned courses. Results: Eighty-eight eligible patients were treated with CHOP-DI and had a median follow-up of 5.1 years on this phase II study, designated Southwest Oncology Group (SWOG) 9349. The progression-free survival was 51% at 2 years and 41% at 5 years. The overall survival was 60% at 5 years. Three fatal treatment-related events occurred. One patient with myelodysplastic syndrome was reported. Conclusion: Treatment with CHOP-DI can be safely administered in the cooperative group setting and results in improved survival. Estimated overall survival at 5 years was 14% better than that of patients treated with standard-dose CHOP in an earlier SWOG study, although progression-free survival of 60% at 2 years-the prespecified end point-was not achieved. CHOP-DI, given every 2 weeks at escalated doses, is a strategy that should be tested in a future randomized clinical trial in lymphoma.

Original languageEnglish (US)
Pages (from-to)2466-2473
Number of pages8
JournalJournal of Clinical Oncology
Volume21
Issue number13
DOIs
StatePublished - Jul 1 2003
Externally publishedYes

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Vincristine
Prednisone
Non-Hodgkin's Lymphoma
Doxorubicin
Cyclophosphamide
Drug Therapy
Survival
Disease-Free Survival
Lymphoma
Burkitt Lymphoma
Myelodysplastic Syndromes
Therapeutics
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Histology
Randomized Controlled Trials
Filgrastim

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma : A phase II study of the Southwest Oncology Group (SWOG 9349). / Blayney, Douglas W.; LeBlanc, Michael L.; Grogan, Thomas; Gaynor, Ellen R.; Chapman, Robert A.; Spiridonidis, C. Harris; Taylor, Sarah A.; Bearman, Scott I.; Miller, Thomas P; Fisher, Richard I.

In: Journal of Clinical Oncology, Vol. 21, No. 13, 01.07.2003, p. 2466-2473.

Research output: Contribution to journalArticle

Blayney, Douglas W. ; LeBlanc, Michael L. ; Grogan, Thomas ; Gaynor, Ellen R. ; Chapman, Robert A. ; Spiridonidis, C. Harris ; Taylor, Sarah A. ; Bearman, Scott I. ; Miller, Thomas P ; Fisher, Richard I. / Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma : A phase II study of the Southwest Oncology Group (SWOG 9349). In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 13. pp. 2466-2473.
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abstract = "Purpose: To test the hypothesis that therapy of intermediate- and high-grade (excluding Burkitt lymphoblastic) lymphoma with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) could be safely dose-intensified with routine filgrastim support. Patients and Methods: Eligible patients were those who were previously untreated and who had either bulky stage II, or stage III or IV lymphoma with working formulation histology D, E, F, G, H, or J; performance status ≤ 2; and acceptable end organ function. No upper age limit was specified. Therapy was dose-intensified CHOP (CHOP-DI) with filgrastim support. Each course was repeated every 14 days for six planned courses. Results: Eighty-eight eligible patients were treated with CHOP-DI and had a median follow-up of 5.1 years on this phase II study, designated Southwest Oncology Group (SWOG) 9349. The progression-free survival was 51{\%} at 2 years and 41{\%} at 5 years. The overall survival was 60{\%} at 5 years. Three fatal treatment-related events occurred. One patient with myelodysplastic syndrome was reported. Conclusion: Treatment with CHOP-DI can be safely administered in the cooperative group setting and results in improved survival. Estimated overall survival at 5 years was 14{\%} better than that of patients treated with standard-dose CHOP in an earlier SWOG study, although progression-free survival of 60{\%} at 2 years-the prespecified end point-was not achieved. CHOP-DI, given every 2 weeks at escalated doses, is a strategy that should be tested in a future randomized clinical trial in lymphoma.",
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T1 - Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma

T2 - A phase II study of the Southwest Oncology Group (SWOG 9349)

AU - Blayney, Douglas W.

AU - LeBlanc, Michael L.

AU - Grogan, Thomas

AU - Gaynor, Ellen R.

AU - Chapman, Robert A.

AU - Spiridonidis, C. Harris

AU - Taylor, Sarah A.

AU - Bearman, Scott I.

AU - Miller, Thomas P

AU - Fisher, Richard I.

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N2 - Purpose: To test the hypothesis that therapy of intermediate- and high-grade (excluding Burkitt lymphoblastic) lymphoma with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) could be safely dose-intensified with routine filgrastim support. Patients and Methods: Eligible patients were those who were previously untreated and who had either bulky stage II, or stage III or IV lymphoma with working formulation histology D, E, F, G, H, or J; performance status ≤ 2; and acceptable end organ function. No upper age limit was specified. Therapy was dose-intensified CHOP (CHOP-DI) with filgrastim support. Each course was repeated every 14 days for six planned courses. Results: Eighty-eight eligible patients were treated with CHOP-DI and had a median follow-up of 5.1 years on this phase II study, designated Southwest Oncology Group (SWOG) 9349. The progression-free survival was 51% at 2 years and 41% at 5 years. The overall survival was 60% at 5 years. Three fatal treatment-related events occurred. One patient with myelodysplastic syndrome was reported. Conclusion: Treatment with CHOP-DI can be safely administered in the cooperative group setting and results in improved survival. Estimated overall survival at 5 years was 14% better than that of patients treated with standard-dose CHOP in an earlier SWOG study, although progression-free survival of 60% at 2 years-the prespecified end point-was not achieved. CHOP-DI, given every 2 weeks at escalated doses, is a strategy that should be tested in a future randomized clinical trial in lymphoma.

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