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An Intensive Chemotherapy of Adult T-Cell Leukemia/Lymphoma: CHOP Followed by Etoposide, Vindesine, Ranimustine, and Mitoxantrone with Granulocyte Colony-Stimulating Factor Support

1996; Lippincott Williams & Wilkins; Volume: 12; Issue: 2 Linguagem: Inglês

10.1097/00042560-199606010-00012

2331-6993

Hirokuni Taguchi, K Kinoshita, Kiyoshi Takatsuki, Masao Tomonaga, Koichi Araki, Naomichi Arima, Shuichi Ikeda, Koji Uozumi, Hidehisa Kohno, Fumio Kawano, Hiroshi Kikuchi, Hironori Takahashi, Kazuo Tamura, S Chiyoda, Hiroyuki Tsuda, H Nishimura, Takafumi Hosokawa, Hiromitsu Matsuzaki, Saburo Momita, Osamu Yamada, Isao Miyoshi,

Animal Disease Management and Epidemiology

An intensive combination chemotherapy regimen supported by granulocyte colony-stimulating factor (G-CSF) was evaluated in adult T-cell leukemia/lymphoma (ATLL) patients in a multiinstitutional, cooperative study. Vincristine 1 mg/m2 i.v. day 1, Adriamycin 40 mg/m2 i.v. day 1, cyclophosphamide 400 mg/m2 i.v. day 1, prednisolone 40 mg/m2 i.v. days 1 to 3 and 8 to 10, etoposide 35 mg/m2 i.v. days 1 to 8, vindesine 2 mg/m2 i.v. day 8, ranimustine 50 mg/m2 i.v. day 8, mitoxantrone 7 mg/m2 i.v. day 8, and G-CSF 50 mg/m2 s.c. days 9 to 21 were given for 2 to 4 courses every 3 weeks to 83 patients with ATLL. Complete remission (CR) and partial remission (PR) were achieved in 35.8 and 38.3 percent, respectively, of 81 evaluable patients. The median survival of all patients was 8.5 months, with a predicted 3-year survival of 13.5 percent by the Kaplan-Meier method. The median duration of response was 7.6 months (range 0.2-42.7), and 13 patients were alive. Their median survival time was 29.1 months (range 19.2-44.7). In 67.6 percent of courses, white blood cell (WBC) nadirs were < 1.0 x 10(9)/L. Days required for the recovery of WBC from the nadir to > 1.0 x 10(9)/L were <5 days in 71.4 percent of the treatment courses. The G-CSF supported an intensified chemotherapy regimen for ATLL and yielded better response rate and longer survival compared to previous reports in Japan. Because duration of remission is still short, further studies of postremission therapy or other strategies are warranted.