Background : In recent study, it was reported there is no difference in response rate,
time to treatment failure, or overall survival between CHOP and the third generation
regimens. However, the cost and toxicity level of the new regimens were higher. Thus,
CHOP remains the best available standard of care. So we assessed the efficacy and the
toxicity of CHOP-Bleo treatment in patients with non-Hodgkin lymphoma.
Methods:
Between June 1988 and October 1994, 65 patients with intermediate grade
and immunoblastic non-Hodgkin lymphorna were treated with CHOP-Bleo regimen. Fifty
three of them were eligible and 48 among them were capable of being evaluated.
Results : The median age was 51 years(range 23∼74) and male to female ratio was
27:21(1.3 : 1). According to the Working Formulation, diffuse large cell, diffuse mixed,
small and large cell type, and immunoblastic type comprised 69%, 21%, and 8%,
respectively. There were low risk 26(54%), low intermediate 9(19%), high intermediate
10(21%), high 3(6%) according to the international index.
Complete remission was achieved in 74%(29/39) and partial remission in 21%(8/39).
With mean follow-up of 28.8 months, the 5-years survival rate was 53% and the
5-years disease free survival was 70%.
Stage, number of extranodal disease sites, and performance status were represented as
statistically significant factors which effect on CR rate. Stage, performance status, serum
LDH, bulky mass, and BM involvement made significant difference in survival rate.
Five-years survival rate of four risk groups according to the international index was
71%, 36%, 47% and 0%, respectively.
The main hematologic toxicitieswere the leukopenia(34.6%) and
thrombocytopenia(4.5%). Non-hematologic side effects were nausea/vomiting(29%),
hepatotoxicity(4.2%), and neurotoxicity(50%).
Received dose intensity of cyclophosphamide, doxorubicin, vincristine and bleomycin
were 221㎎/㎡/wk, 14.6㎎/㎡/㎖/wk, 1.16㎎/wk and 8.88㎎/wk, respectively.
Conclusion: CHOP-Bleo is an effective treatment regimen for the intermediate grade
and immunoblastic non-Hodgkin lymphoma, based on high complete remission rate,
disease-free and overall survival, but lower costs.

Keywords: Non-Hodgkin lymphoma, CHOP-Bleo chemotherapy