Lymphoma. Hodgkinlymfomen and non-Hodgkin's disease
Information on current developments in both regular and alternative or complementary treatments and resources for lymphoma - non-Hodgkin's lymphoma and Hodgkin's disease at all stages.
Recent articles in left column more or less in alphabetical order classified
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Chemo and effect in lymphoma: Patients with Hodgkin's disease would benefit from new chemomix - with increased dose BEACOPP - and would not benefit from additional radiotherapy radiotherapy after chemotherapy according to two long-term randomized trials. Update November 27, 2010
June 12, 2003: Source: Medscape and N Engl J Med. 2003, 348:2375-2376, 2386-2395, 2396-2406Two randomized studies of an approach to Hodgkin's disease show that a new chemotherapy combination was significantly better results in survival and that additional radiotherapy radiotherapy after chemotherapy is useless and the patient with Hodgkin's disease without radiotherapy / radiation even better survival chances .
Chemotherapy with increased dose BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) provides significantly better results in the final survival than hitherto used chemotherapy combination COPP-ABVD (cyclophosphamide, vincristine, procarbazine and prednisone alternating with doxorubicin, bleomycin, vinblastine, and dacarbazine) or the standard BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone), but with lower doses. Of the 1201 patients followed in the period 1993 to 1998, aged 15 to 65 years 1195 patients were evaluated for this study. The COPP-ABVD group disbanded in 1996 due to poor interim results.
Of the 1195 patients, the disease-free condition after five years 69% in the COPP-ABVD group, 76% in the BEACOPP group (P = .04), and 87% of the increased dose BEACOPP group (P <.001). Five-year survival was 83% in the COPP-ABVD group, 88% in the BEACOPP group, and 91% for the increased dose BEACOPP group (P = .06 compared with BEACOPP and P = .002 compared with COPP-ABVD). Not so bad results for the treatment of Hodgkin's disease (no comparison with non-Hodgkin Moreover, where a very different approach to it). Remarkable is that the group treated with BEACOPP, both standard and with increased dose, but nine patients developed a form of acute leukemia. This is according to the researchers the more striking because the chemo regimen AVBD a low 'leukemogenicity "(do not know a word for it in Dutch) has usually. Further studies are thus necessary to them.
Another study of 739 patients with Hodgkin's disease stage III and IV, all of which already had achieved a complete remission of a joke ABV hybrid chemotherapy, investigated the effect and / or benefit from additional radiotherapy / radiation. 421 patients from the total group of 739 patients achieved a complete remission. The overall five year survival with no regression in that moment five years was 84% in the group receiving no additional radiotherapy received radiation compared to 79% in the group that radiotherapy received radiation (P = .35).
Overall five year survival was 91% in the group without radiotherapy / radiation compared with 85% in the group that additional radiotherapy / radiation received. (P = .07). Among the 250 patients who had a partial remission after chemotherapy, overall survival was no regression time within five years and 79% five-year overall survival 87%. The conclusion of the researchers is that additional therapy after chemotherapy for Hodgkin's disease has no benefit especially given the sometimes serious long term side effects of combination chemotherapy and radiotherapy irradiation.
Source: Medscape: Reviewed by Gary D. Vogin, MD
Two Studies Clarify Optimal Treatment of Hodgkin's Disease
Laurie Barclay, MD
June 11, 2003 - Two Studies Reported in the June 1912 issue of the New England Journal of Medicine Clarify better optimal treatment or Hodgkin's disease (HD). The first shows That Increased dose combination chemotherapy improves survival rates and Reduces or treatment failure, while the second sacrifices Study Shows That radiotherapy no benefit to Those Who Achieve complete remission.
"Increased-dose BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) resulted in better tumor control and overall survival did COPP-ABVD Than (cyclophosphamide, vincristine, procarbazine, and prednisone alternating with doxorubicin, bleomycin, vinblastine , and dacarbazine), "write Volker Diehl, MD, and colleagues from the Germantown Hodgkin's Lymphoma Study Group.
From 1993 to 1998, 1201 patient, aged 15 to 65 years, with newly diagnosed, advanced HD Were randomized to eight cycles of COPP-ABVD, BEACOPP to, or to Increased-dose BEACOPP, followed by local radiotherapy Each axis Needed. In 1996, enrollment in the COPP-ABVD group stopped becauses inferior or interim results.
Among 1195 evaluable patient, the rate of freedom from treatment failure at five years was 69% in the COPP-ABVD group, 76% in the BEACOPP group (P = .04), and 87% in the Increased-dose BEACOPP group (P <.001). Five-year survival was 83% in the COPP-ABVD group, 88% in the BEACOPP group, and 91% for the Increased-dose BEACOPP group (P = .06 compared with BEACOPP and P = .002 compared with COPP-ABVD) .
"The occurrence of nine cases of acute leukemia after Increased-dose BEACOPP Seems alarms, Especially as compared with the low leukemogenicity of the ABVD regimen," the authors write. "Further Study is Needed before a reli-able assessment of the long-term risks of Standard and Increased-dose BEACOPP Can Be Made."
In a separate study, patient with Previously untreated stage III or IV Hodgkin's Disease who Were in complete remission after hybrid chemotherapy with MOPS-ABV Were Either randomized to receive treatment or No Further Involved-field radiotherapy.
Of 739 patient, 421 had a complete remission. Five-year event-free survival was 84% in the group That did not receive radiotherapy and 79% in the Group That Received Involved-field radiotherapy (P = .35). Five-year overall survival was 91% in the group not Treated with radiotherapy and 85% in the group That did receive radiotherapy (P = .07).
Among 250 patients in partial remission after chemotherapy, five-year event-free survival was 79% and five-year overall survival was 87%.
"There is no need for Involved-field radiotherapy to maintainAspectRatio remission in patient with stage III or IV Hodgkin's lymphoma after six to eight cycles or MOPS-ABV chemotherapy," write Berthe MP Aleman, MD, and colleagues from the European Organization for Research and Treatment of Cancer Lymphoma Group. "The only patiënten who benefit from radiotherapy Those are in partial remission after the chemotherapy."
Accompanying In an editorial, Vincent T. DeVita, Jr.., MD, from Yale University in New Haven, Connecticut, reviews the history of treatment for Hodgkin's disease and notes thats in clinical trials, "combination chemotherapy was added to radiotherapy for early-stage disease Rather Than Tested Further as a substitute for it .... The long-term effect of Carcinogenic Combining chemotherapy with radiotherapy HAS Turned out to be far too severe, however, to warrant continuing with this approach. "
N Engl J Med. 2003, 348:2375-2376, 2386-2395, 2396-2406
Reviewed by Gary D. Vogin,MD
