COMBINATION CHEMOTHERAPY OF ADVANCED NON-HODGKIN LYMPHOMA WITH BLEOMYCIN, ADRIAMYCIN, CYCLOPHOSPHAMIDE, VINCRISTINE, AND PREDNISONE (BACOP)

Abstract

Seventy-three patients with advanced non-Hodgkin lymphoma were treated with BACOP, administered intensively during a 7 wk induction course followed by intermittent cycles every 3 wk, for a total of 28 wk. The objective response in 44 evaluable nonleukemic patients with diffuse histology was 86%, with 66% achieving a complete remission (CR), varying from 80% for diffuse poorly differentiated lymphocytic (DPDL) to 56% for diffuse histiocytic (DH) lymphoma. In patients with nodular histology 89% (8/9) achieved a CR with a projected 75% of patients in CR at 14 mo. Median follow-up from time of CR for nodular histology was 17 mo. The projected median duration of CR in diffuse histology was 14 mo., with median survival 14 mo. Patients with a partial response survived a median of 7 mo., compared to 3 mo. for nonresponders. Of 29 patients with diffuse histology, 17 (59%) have remained disease free for 5-34 mo. with a median follow-up of 12 mo. Survival beyond 20 mo. was projected for 42% of patients with diffuse histology (58% with DPDL and 32% with DH). The CNS was involved in 11/44 (25%) patients with diffuse histology, including 5 with primary CNS relapse. BACOP resulted in a higher CR rate and longer survival than a previous 3 drug program (COP) [cyclophosphamide, vincristine, prednisone] especially in patients with diffuse histology.