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Intensive chemotherapy in the treatment of aggressive diffuse large B-cell lymphoma

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Abstract

The aim of the present study was to evaluate an intensive chemotherapy regimen in patients with diffuse large B-cell lymphoma and poor prognosis, as presence of high- or high-intermediate clinical risk, bulky disease, high levels of beta 2 microgloblin, and more than two extranodal sites of involvement at diagnosis.

One hundred previously untreated patients were treated with an intensive CEOP-Bleo regimen with increased doses of cyclophosphamide (1000 mg/m2) and epirubicin (120 mg/m2) in each cycle. Granulocyte colony-stimulating factors was employed to ameliorate severe granulocytopenia.

Complete response was achieved in 79 cases (79%). With a median follow-up of 32.3 mo (range 10–45 mo) only seven patients have relapsed. Thus, actuarial curves at 3 yr, showed that event-free survival was 72%. Five died secondary to tumor progression, actuarial curves at 3-yr for overall survival were 75%. Toxicity was mild, granulocytopenia grade III or IV were observed in the 46% of the cycles; infection-related granulocytopenia was observed in 17%, but no fatality due to therapy was observed. Cardiac toxicity was mild, only seven patients showed a drop in left ejection ventricular function, but no symptomatic heart failure has been observed.

The intensive CEOP-Bleo regimen with increasing doses of cyclophosphamide and epirubicin is a useful and well-tolerated regimen in the treatment of poor prognosis diffuse large B-cell lymphoma.

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Authors and Affiliations

  1. Oncology Research Unit, Oncology Hospital, National Medical Center, IMSS, México, D.F., Mexico

    Agustin Avilés MD

  2. Department of Hematology, Oncology Hospital, National Medical Center, IMSS, México, D.F., Mexico

    M. Jesús Nambo, Natividad Neri, Alejandra Talavera, Claudia Castañeda, Edgar Murillo, Sergio Cleto & Judith Huerta-Guzmán

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  1. Agustin Avilés MD
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  2. M. Jesús Nambo
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  3. Natividad Neri
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  4. Alejandra Talavera
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  5. Claudia Castañeda
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  6. Edgar Murillo
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  7. Sergio Cleto
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  8. Judith Huerta-Guzmán
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Correspondence to Agustin Avilés MD.

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Avilés, A., Jesús Nambo, M., Neri, N. et al. Intensive chemotherapy in the treatment of aggressive diffuse large B-cell lymphoma. Med Oncol 21, 269–272 (2004). https://doi.org/10.1385/MO:21:3:269

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