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Nodular mixed lymphoma: results of a randomized trial failing to confirm
prolonged disease-free survival with COPP chemotherapy
JH Glick, JM Barnes, EZ Ezdinli, CW Berard, EL Orlow and JM Bennett
Fifty-two patients with stage III or IV nodular mixed lymphocytic-
histiocytic lymphoma (NM) were entered on a prospective randomized trial
comparing cyclophosphamide-prednisone (CP) to either COPP
(cyclophosphamide, vincristine, procarbazine, prednisone) or BCVP (BCNU,
cyclophosphamide, vincristine, prednisone). The COPP regimen utilized in
this Eastern Cooperative Oncology Group (ECOG) trial was similar to the
four-drug regimen C-MOPP reported by the National Cancer Institute to
achieve prolonged relapse-free survival in this histology. No significant
differences in complete response rates, response duration, or overall
survival were noted among the three regimens. A pattern of continuous late
relapse was observed for all three chemotherapy programs. Although 11 of
the 18 (61%) COPP patients achieved a complete response, only 3/11 (27%)
remain disease-free with a median follow-up of over 3 yr. However, two of
these three long-term complete responders have died with no clinical
evidence of recurrent disease. The COPP patients received 84% of the
calculated ideal doses of cyclophosphamide and 78% of the ideal dosage of
procarbazine. Grade 3-4 hematologic toxicity was noted in 22% of the COPP
group, 36% with BCVP, and 0% for the CP patients. We were unable to confirm
the ability of COPP to achieve durable complete remissions in NM lymphoma.
The cyclophosphamide-prednisone combination was equally effective when
compared with COPP and BCVP, but produced minimal toxicity.
Volume 58,
Issue 5,
pp. 920-925,
11/01/1981
Copyright © 1981 by The American Society of Hematology
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