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CEPP(B): an effective and well-tolerated regimen in poor-risk, aggressive
non-Hodgkin's lymphoma
NJ Chao, SA Rosenberg and SJ Horning
Department of Medicine, Stanford University School of Medicine, CA
94305-5306.
Eighty-three patients with intermediate- or high-grade non-Hodgkin's
lymphoma were treated with CEPP(B) (cyclophosphamide, etoposide [VP- 16],
procarbazine, and prednisone with or without bleomycin) chemotherapy at
Stanford University Medical Center (Stanford, CA) from January 1982 through
June 1989. Sixty-nine received CEPP(B) as second- line or subsequent
therapy after relapse from previous combination chemotherapy, and 14
patients received CEPP(B) as first-line therapy. Of 75 patients evaluable
for response, 30 patients (40%) achieved a complete response (CR) and 24
patients (32%) achieved a partial response (PR), providing an overall
response rate of 72%. Complete responses were recorded on 21 of 61 (34%)
patients with recurrent disease and 9 of the 14 patients who received
CEPP(B) as first line therapy (64%). Myelosuppression was the major side
effect of treatment, resulting in eight neutropenic-febrile episodes from a
total of 253 courses. A single fatal toxic event occurred on a patient who
developed adult respiratory distress syndrome. Overall, CEPP(B) was well-
tolerated and proved to be effective palliative therapy for patients with
non-Hodgkin's lymphoma after relapse. As such, CEPP(B) may be considered
for cytoreduction before ablative therapy and bone marrow transplantation.
CEPP(B) may also be considered for initial therapy in selected patients who
cannot tolerate doxorubicin-containing regimens.
Volume 76,
Issue 7,
pp. 1293-1298,
10/01/1990
Copyright © 1990 by The American Society of Hematology
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