Final Results of Cooperative Study of VEPA [Vincristine, Cyclophosphamide (Endoxan), Prednisolone and Adriamycin] Therapy in Advanced Adult Non-Hodgkin's Lymphoma: Relation Between T- or B-Cell Phenotype and Response

• Published in: Japanese journal of clinical oncology 1982-08, Vol.12 (2), p.227-237
• Main Authors: SHIMOYAMA, Masanori, ICHIMARU, Michito, YUNOKI, Kazuo, OOTA, Kazuo, OGAWA, Makoto
• Format: Article
• Language: English
• ISSN: 0368-2811; 1465-3621; 1465-3621
• DOI: 10.1093/oxfordjournals.jjco.a038812

One hundred previously untreated adult patients with advanced non-Hodgkin's lymphomas were treated with VEPA (vincristine, cyclophosphamide, prednisolone and adriamycin in combination) therapy. The overall complete remission rate was 52%. The complete remission rate was markedly higher in the patients with lineage-undetermined lymphomas (72.2%) as well as in the patients with B(non-T)-cell lymphomas (58.5%) than in the patients with T-cell lymphomas (36.6%). The median duration of complete remission has not been reached for lineage-undetermined lymphomas and most (77%) of the patients have been in remission for more than 2-yr, while the median duration of complete remission for B(non-T)-cell type was 16 mo with a 3-yr remission rate of 14%, and median duration for the T-cell type was only 4 mo with a 2-yr remission rate of 15% or less. Both complete remission and cell lineage of lymphomas markedly affected the survival period. Of the patients who were not induced into complete remission, about 90% died within 12 mo regardless of the cell lineage of the lymphoma, and their median survival was only 5–7 mo. On the other hand, more than 90% of the patients with lineage-undetermined lymphomas who were induced into complete remission are still alive after 36 mo. Median survival was 37 mo and the 3-yr survival rate was 56.1% in the case of B(non-T)-cell lymphoma with complete remission. Even in the T-cell lymphomas, significantly (a few months) longer survival time will be expected in the patients in complete remission. These facts indicate that complete remission induced by VEPA therapy contributes greatly to longer survival of the patients, but its contribution is limited by the cell lineage of the lymphoma. B(non-T)-cell lymphoma as well as lineage-undetermined lymphoma responded well to VEPA therapy and some of the patients may be cured. On the other hand, T-cell lymphoma responded poorly to VEPA therapy.