Korean J Hematol 2003; 38(1):
Published online March 31, 2003
© The Korean Society of Hematology
성인 림프모구림프종 환자의 항암화학요법에 따른 치료성적 분석
김동완, 선종무, 권정혜, 오도연, 이재진, 조요한, 김태유, 윤성수, 허대석, 방영주, 박선양, 김병국, 김노경
서울대학교 의과대학 내과학교실
An Analysis of Treatment Results of Lymphoblastic Lymphoma in Adults According to the Chemotherapy Regimens
BACKGROUND: This study was done to analyze the treatment outcomes of adult lymphoblastic lymphoma patients according to the risk groups and the treatment regimens.
METHODS : The analysis was performed on twenty patients histologically diagnosed as lymphoblastic lymphoma at Seoul National University Hospital. The high-risk group was defined as patients with Ann Arbor stage IV with bone marrow, central nervous system (CNS) involvement or initial serum lactate dehydrogenase level more than 1.5 times
upper normal limits. Twelve patients received dose-intensive Stanford/Northern California Oncology Group (NCOG) regimen consisted of four phase of induction, CNS prophylaxis, consolidation, and maintenance. Eight patients received conventional dose regimen, either six courses of vincristine, bleomycin, cyclophosphamide, doxorubicin, prednisolone, procarbazine (COPBLAM-V) or cyclophosphamide, vincristine, doxorubicin, prednisolone, L-asparaginase (CHOP/L-ASP) with CNS prophylaxis. We analyzed the
response rate and the survival rate according to the risk groups and treatment regimens.
RESULTS: The overall response rate was 90% (75% complete response). In low-risk group, the complete response (CR) rate was 100% irrespective of treatment regimen. In high-risk group, conventional dose regimen did not produce CR. Four of the six high-risk patients receiving dose-intensive regimen achieved CR. The 5-year overall survival (OS) rate was 52% in total patients. The 5-year OS rate were 77% and 30% for low- and high-risk group, respectively (P=0.242). In low-risk group, conventional dose regimen showed similar survival outcomes compared with that of dose intensive regimen. Toxicity profile was more favorable in the patients with conventional dose regimens.
CONCLUSION : For low-risk patients, conventional dose regimen showed similar effect in comparison with dose-intensive regimen. However, for high-risk patients, CR was observed only with dose-intensive regimen. Multi-center clinical trials are necessary to confirm our observation.
Keywords Lymphoma; Lymphoblastic; Survival; Drug therapy;
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Korean J Hematol 2003; 38(1): 32-39
Published online March 31, 2003
Copyright © The Korean Society of Hematology.
성인 림프모구림프종 환자의 항암화학요법에 따른 치료성적 분석
김동완, 선종무, 권정혜, 오도연, 이재진, 조요한, 김태유, 윤성수, 허대석, 방영주, 박선양, 김병국, 김노경
서울대학교 의과대학 내과학교실
An Analysis of Treatment Results of Lymphoblastic Lymphoma in Adults According to the Chemotherapy Regimens
Dong Wan Kim, Jong Mu Sun, Jung Hye Kwon, Do Youn Oh, Jae Jin Lee, Yo Han Jo, Tae You Kim, Sung Soo Yoon, Dae Seog Heo, Yung Jue Bang, Seon Yang Park, Byoung Kook Kim, Noe Kyeong Kim
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
Abstract
BACKGROUND: This study was done to analyze the treatment outcomes of adult lymphoblastic lymphoma patients according to the risk groups and the treatment regimens.
METHODS : The analysis was performed on twenty patients histologically diagnosed as lymphoblastic lymphoma at Seoul National University Hospital. The high-risk group was defined as patients with Ann Arbor stage IV with bone marrow, central nervous system (CNS) involvement or initial serum lactate dehydrogenase level more than 1.5 times
upper normal limits. Twelve patients received dose-intensive Stanford/Northern California Oncology Group (NCOG) regimen consisted of four phase of induction, CNS prophylaxis, consolidation, and maintenance. Eight patients received conventional dose regimen, either six courses of vincristine, bleomycin, cyclophosphamide, doxorubicin, prednisolone, procarbazine (COPBLAM-V) or cyclophosphamide, vincristine, doxorubicin, prednisolone, L-asparaginase (CHOP/L-ASP) with CNS prophylaxis. We analyzed the
response rate and the survival rate according to the risk groups and treatment regimens.
RESULTS: The overall response rate was 90% (75% complete response). In low-risk group, the complete response (CR) rate was 100% irrespective of treatment regimen. In high-risk group, conventional dose regimen did not produce CR. Four of the six high-risk patients receiving dose-intensive regimen achieved CR. The 5-year overall survival (OS) rate was 52% in total patients. The 5-year OS rate were 77% and 30% for low- and high-risk group, respectively (P=0.242). In low-risk group, conventional dose regimen showed similar survival outcomes compared with that of dose intensive regimen. Toxicity profile was more favorable in the patients with conventional dose regimens.
CONCLUSION : For low-risk patients, conventional dose regimen showed similar effect in comparison with dose-intensive regimen. However, for high-risk patients, CR was observed only with dose-intensive regimen. Multi-center clinical trials are necessary to confirm our observation.
Keywords: Lymphoma, Lymphoblastic, Survival, Drug therapy,
