CNOP for diffuse aggressive non-Hodgkin's lymphoma

The Nebraska Lymphoma Study Group experience

Julie Marie Vose, Dennis D. Weisenburger, James C. Lynch, Philip Jay Bierman, John C. Chan, Martin Bast, Patricia Aoun, Robert G Bociek, Timothy Charles Greiner, James Olen Armitage, Charles Arthur Enke, John Okerbloom, Julie Vose, Robert Warne, William Schleuter, Sitki Copur, David Howe, Craig Nichols, George Bascom, Cynthia Lewis & 24 others Mark Hutchins, Daniel Moravec, Alan Berg, Cary Peterson, Scott Sorensen, Susan Hansen, Patrick Judson, Lana Scott-Timperly, Robert Langdon, Margaret Block, Peter Townley, Stephen Lemon, David Silverberg, Gamini Soori, Herbert Hartman, Douglas Jones, Vincent Bjorling, William Packard, David Garfield, Jeffery Matous, Robert Rifkin, Robert Berris, Nicholas DiBella, Kyle Fink

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The purpose of this study was to evaluate the CNOP regimen (cyclophosphamide, mitoxantrone, vincristine, and prednisone) throughout a community based oncology network with a large number of elderly non-Hodgkin's lymphoma (NHL) patients. Three hundred and seventy-three previously untreated patients with diffuse aggressive NHL received the CNOP regimen administered through a community oncology network, the Nebraska Lymphoma Study Group (NLSG). The complete response rate was 60% with an overall response rate of 73%. The estimated 4-year event-free survival for patients <60 years was 44%, compared to 38% for those >age 60 (p = 0.18). However, the 4-year estimated overall survival for patients <60 years was 62% compared to 44% for those >60 years (p < 0.001). Prognostic factors predictive for a poor event-free survival were male gender, stage III/IV disease, Karnofsky score <80, and elevated lactic dehydrogenase (LDH). The lymphoma specific cumulative death rate was 29% for patients <60 years compared with 33% for patients >60 years (p = 0.07). After failing CNOP the 4-year overall survival (OS) was 19%. The estimated 4-year OS for patients who failed CNOP and went on to receive high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplant (ASCT) was 64% for patients <age 60 and 48% for those >60 years (p = 0.23). In conclusion, CNOP chemotherapy administered to patients with diffuse aggressive NHL in a community oncology network produces similar result to that reported for other anthracycline based regimens reported in the literature. Patients >age 60 had a higher rate of failure due to causes other than lymphoma which accounted for a worse survival long-term. However, patients of all ages who failed CNOP and who were able to receive HDC and ASCT demonstrated long-term disease survival after the transplant.

Original languageEnglish (US)
Pages (from-to)799-804
Number of pages6
JournalLeukemia and Lymphoma
Volume43
Issue number4
DOIs
StatePublished - May 6 2002

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Non-Hodgkin's Lymphoma
Lymphoma
Community Networks
Survival
Hematopoietic Stem Cells
Transplants
Drug Therapy
Mitoxantrone
Anthracyclines
Vincristine
Prednisone
Cyclophosphamide
Disease-Free Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

CNOP for diffuse aggressive non-Hodgkin's lymphoma : The Nebraska Lymphoma Study Group experience. / Vose, Julie Marie; Weisenburger, Dennis D.; Lynch, James C.; Bierman, Philip Jay; Chan, John C.; Bast, Martin; Aoun, Patricia; Bociek, Robert G; Greiner, Timothy Charles; Armitage, James Olen; Enke, Charles Arthur; Okerbloom, John; Vose, Julie; Warne, Robert; Schleuter, William; Copur, Sitki; Howe, David; Nichols, Craig; Bascom, George; Lewis, Cynthia; Hutchins, Mark; Moravec, Daniel; Berg, Alan; Peterson, Cary; Sorensen, Scott; Hansen, Susan; Judson, Patrick; Scott-Timperly, Lana; Langdon, Robert; Block, Margaret; Townley, Peter; Lemon, Stephen; Silverberg, David; Soori, Gamini; Hartman, Herbert; Jones, Douglas; Bjorling, Vincent; Packard, William; Garfield, David; Matous, Jeffery; Rifkin, Robert; Berris, Robert; DiBella, Nicholas; Fink, Kyle.

In: Leukemia and Lymphoma, Vol. 43, No. 4, 06.05.2002, p. 799-804.

Research output: Contribution to journalArticle

Vose, JM, Weisenburger, DD, Lynch, JC, Bierman, PJ, Chan, JC, Bast, M, Aoun, P, Bociek, RG, Greiner, TC, Armitage, JO, Enke, CA, Okerbloom, J, Vose, J, Warne, R, Schleuter, W, Copur, S, Howe, D, Nichols, C, Bascom, G, Lewis, C, Hutchins, M, Moravec, D, Berg, A, Peterson, C, Sorensen, S, Hansen, S, Judson, P, Scott-Timperly, L, Langdon, R, Block, M, Townley, P, Lemon, S, Silverberg, D, Soori, G, Hartman, H, Jones, D, Bjorling, V, Packard, W, Garfield, D, Matous, J, Rifkin, R, Berris, R, DiBella, N & Fink, K 2002, 'CNOP for diffuse aggressive non-Hodgkin's lymphoma: The Nebraska Lymphoma Study Group experience', Leukemia and Lymphoma, vol. 43, no. 4, pp. 799-804. https://doi.org/10.1080/10428190290016917
Vose, Julie Marie ; Weisenburger, Dennis D. ; Lynch, James C. ; Bierman, Philip Jay ; Chan, John C. ; Bast, Martin ; Aoun, Patricia ; Bociek, Robert G ; Greiner, Timothy Charles ; Armitage, James Olen ; Enke, Charles Arthur ; Okerbloom, John ; Vose, Julie ; Warne, Robert ; Schleuter, William ; Copur, Sitki ; Howe, David ; Nichols, Craig ; Bascom, George ; Lewis, Cynthia ; Hutchins, Mark ; Moravec, Daniel ; Berg, Alan ; Peterson, Cary ; Sorensen, Scott ; Hansen, Susan ; Judson, Patrick ; Scott-Timperly, Lana ; Langdon, Robert ; Block, Margaret ; Townley, Peter ; Lemon, Stephen ; Silverberg, David ; Soori, Gamini ; Hartman, Herbert ; Jones, Douglas ; Bjorling, Vincent ; Packard, William ; Garfield, David ; Matous, Jeffery ; Rifkin, Robert ; Berris, Robert ; DiBella, Nicholas ; Fink, Kyle. / CNOP for diffuse aggressive non-Hodgkin's lymphoma : The Nebraska Lymphoma Study Group experience. In: Leukemia and Lymphoma. 2002 ; Vol. 43, No. 4. pp. 799-804.
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abstract = "The purpose of this study was to evaluate the CNOP regimen (cyclophosphamide, mitoxantrone, vincristine, and prednisone) throughout a community based oncology network with a large number of elderly non-Hodgkin's lymphoma (NHL) patients. Three hundred and seventy-three previously untreated patients with diffuse aggressive NHL received the CNOP regimen administered through a community oncology network, the Nebraska Lymphoma Study Group (NLSG). The complete response rate was 60{\%} with an overall response rate of 73{\%}. The estimated 4-year event-free survival for patients <60 years was 44{\%}, compared to 38{\%} for those >age 60 (p = 0.18). However, the 4-year estimated overall survival for patients <60 years was 62{\%} compared to 44{\%} for those >60 years (p < 0.001). Prognostic factors predictive for a poor event-free survival were male gender, stage III/IV disease, Karnofsky score <80, and elevated lactic dehydrogenase (LDH). The lymphoma specific cumulative death rate was 29{\%} for patients <60 years compared with 33{\%} for patients >60 years (p = 0.07). After failing CNOP the 4-year overall survival (OS) was 19{\%}. The estimated 4-year OS for patients who failed CNOP and went on to receive high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplant (ASCT) was 64{\%} for patients 60 years (p = 0.23). In conclusion, CNOP chemotherapy administered to patients with diffuse aggressive NHL in a community oncology network produces similar result to that reported for other anthracycline based regimens reported in the literature. Patients >age 60 had a higher rate of failure due to causes other than lymphoma which accounted for a worse survival long-term. However, patients of all ages who failed CNOP and who were able to receive HDC and ASCT demonstrated long-term disease survival after the transplant.",
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T1 - CNOP for diffuse aggressive non-Hodgkin's lymphoma

T2 - The Nebraska Lymphoma Study Group experience

AU - Vose, Julie Marie

AU - Weisenburger, Dennis D.

AU - Lynch, James C.

AU - Bierman, Philip Jay

AU - Chan, John C.

AU - Bast, Martin

AU - Aoun, Patricia

AU - Bociek, Robert G

AU - Greiner, Timothy Charles

AU - Armitage, James Olen

AU - Enke, Charles Arthur

AU - Okerbloom, John

AU - Vose, Julie

AU - Warne, Robert

AU - Schleuter, William

AU - Copur, Sitki

AU - Howe, David

AU - Nichols, Craig

AU - Bascom, George

AU - Lewis, Cynthia

AU - Hutchins, Mark

AU - Moravec, Daniel

AU - Berg, Alan

AU - Peterson, Cary

AU - Sorensen, Scott

AU - Hansen, Susan

AU - Judson, Patrick

AU - Scott-Timperly, Lana

AU - Langdon, Robert

AU - Block, Margaret

AU - Townley, Peter

AU - Lemon, Stephen

AU - Silverberg, David

AU - Soori, Gamini

AU - Hartman, Herbert

AU - Jones, Douglas

AU - Bjorling, Vincent

AU - Packard, William

AU - Garfield, David

AU - Matous, Jeffery

AU - Rifkin, Robert

AU - Berris, Robert

AU - DiBella, Nicholas

AU - Fink, Kyle

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N2 - The purpose of this study was to evaluate the CNOP regimen (cyclophosphamide, mitoxantrone, vincristine, and prednisone) throughout a community based oncology network with a large number of elderly non-Hodgkin's lymphoma (NHL) patients. Three hundred and seventy-three previously untreated patients with diffuse aggressive NHL received the CNOP regimen administered through a community oncology network, the Nebraska Lymphoma Study Group (NLSG). The complete response rate was 60% with an overall response rate of 73%. The estimated 4-year event-free survival for patients <60 years was 44%, compared to 38% for those >age 60 (p = 0.18). However, the 4-year estimated overall survival for patients <60 years was 62% compared to 44% for those >60 years (p < 0.001). Prognostic factors predictive for a poor event-free survival were male gender, stage III/IV disease, Karnofsky score <80, and elevated lactic dehydrogenase (LDH). The lymphoma specific cumulative death rate was 29% for patients <60 years compared with 33% for patients >60 years (p = 0.07). After failing CNOP the 4-year overall survival (OS) was 19%. The estimated 4-year OS for patients who failed CNOP and went on to receive high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplant (ASCT) was 64% for patients 60 years (p = 0.23). In conclusion, CNOP chemotherapy administered to patients with diffuse aggressive NHL in a community oncology network produces similar result to that reported for other anthracycline based regimens reported in the literature. Patients >age 60 had a higher rate of failure due to causes other than lymphoma which accounted for a worse survival long-term. However, patients of all ages who failed CNOP and who were able to receive HDC and ASCT demonstrated long-term disease survival after the transplant.

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