No Initial Therapy for Stage III and IV Non-Hodgkin's Lymphomas of Favorable Histologic Types

Abstract

The question of whether initial treatment [chemotherapy] is necessary in relatively asymptomatic patients with stage III and and IV non-Hodgkin''s lymphomas of favorable histologic types was studied by retrospective analysis. Two groups of patients were studied: [1] 44 nonprotocol patients, followed since 1963, in whom initial treatment was withheld until required to evaluate the pace of disease and the necessity of treatment; and [2] 112 previously untreated patients who have participated in prospectively randomized clinical trials since 1971. For group 1 patients, the median time before requiring treatment was 31 mo., and there have been 19 patients who have not yet required therapy for periods of 3 to 104 mo. The median actuarial survival for group 1 was 121 mo. At 4 yr, the actuarial survival of group 1 with deferred treatment is 77.3%, compared with 83.2% for group 2 patients (P = 0.60). Careful observation without initiation of therapy is an appropriate option in the management of patients with relatively asymptomatic advanced non-Hodgkin''s lymphomas of favorable histologic types.