Revision as of 01:09, 12 March 2017

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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only. As a general rule, this includes the inferior arm(s) of a randomized study, unless said regimens continue to be recommended by trustworthy sources such as the NCCN Guidelines. See the DLBCL page for current regimens.

67 regimens on this page 85 variants on this page

Untreated

ABP

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ABP: Adriamycin (Doxorubicin), Bleomycin, Prednisone

Regimen

Study	Evidence	Comparator
Monfardini et al. 1977	Phase III	CVP

Chemotherapy

References

Monfardini S, Tancini G, DeLena M, Villa E, Valagussa P, Bonadonna G. Cyclophosphamide, vincristine, and prednisone (CVP) versus adriamycin, bleomycin, and prednisone (ABP) in stage IV non-Hodgkin's lymphomas. Med Pediatr Oncol. 1977;3(1):67-74. PubMed

ACE

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ACE: Adriamycin (Doxorubicin), Cyclophosphamide, Etoposide

Regimen

Study	Evidence	Comparator
Dumontet et al. 2000	Phase II
Haioun et al. 2009	Phase III	ACVBP

Chemotherapy

References

Dumontet C, Thieblemont C, Espinouse D, Bouafia F, Hequet O, Salles G, Coiffier B. A prospective study of intensive induction therapy with high-dose consolidation in patients with aggressive non-Hodgkin's lymphoma and two or three adverse prognostic factors. Leukemia. 2000 Dec;14(12):2159-65. PubMed
Haioun C, Mounier N, Emile JF, Ranta D, Coiffier B, Tilly H, Récher C, Fermé C, Gabarre J, Herbrecht R, Morchhauser F, Gisselbrecht C. Rituximab versus observation after high-dose consolidative first-line chemotherapy with autologous stem-cell transplantation in patients with poor-risk diffuse large B-cell lymphoma. Ann Oncol. 2009 Dec;20(12):1985-92. Epub 2009 Jun 30. link to original article PubMed

ACOMLA

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ACOMLA: Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine), Methotrexate, Leucovorin (Folinic acid), Ara-C (Cytarabine)

Regimen

Study	Evidence	Comparator
Newcomer et al. 1982	Randomized, <20 patients	CHOP-B

Chemotherapy

References

Newcomer LN, Cadman EC, Nerenberg MI, Chen M, Bertino JR, Farber LR, Prosnitz LR. Randomized study comparing doxorubicin, cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (ACOMLA) with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-B) in the treatment of diffuse histiocytic lymphoma. Cancer Treat Rep. 1982 Jun;66(6):1279-84. PubMed

ACVBP

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ACVBP: Adriamycin (Doxorubicin), Cyclophosphamide, Vindesine, Bleomycin, Prednisone

Regimen

Study	Evidence	Comparator
Tilly et al. 2000 (LNH87-1)	Phase III	m-BACOD
Tilly et al. 2003	Phase III	CHOP
Reyes et al. 2005	Phase III	CHOP -> RT
Haioun et al. 2009	Phase III	ACE
Ketterer et al. 2013 (LNH03-1B)	Phase III	ACVBP-R

Induction Regimen

Doxorubicin (Adriamycin) 75 mg/m² IV once on day 1
Cyclophosphamide (Cytoxan) 1200 mg/m² IV once on day 1
Vindesine (Eldisine) 2 mg/m² IV once per day on days 1 & 5
Bleomycin (Blenoxane) 10 units IV once per day on days 1 & 5
Prednisone (Sterapred) 60 mg/m² PO once per day on days 1 to 5

CNS prophylaxis:

Methotrexate (MTX) 15 mg intrathecal on day 2

Supportive medications

G-CSF or GM-CSF SC once per day on days 6 to 13

21-day cycle for 4 cycles, followed by:

Consolidation Regimen, part 1

Methotrexate (MTX) 3000 mg/m² IV once on day 1

Supportive medications

Leucovorin rescue

14-day cycle for 2 cycles, followed by:

Consolidation Regimen, part 2

Etoposide (Vepesid) 300 mg/m² IV once on day 1
Ifosfamide (Ifex) 1500 mg/m² IV once on day 1

Supportive medications

Mesna (Mesnex) "protection" (details not provided)

14-day cycle for 4 cycles, beginning 2 weeks after completion of MTX, then

Consolidation Regimen, part 3

Cytarabine (Cytosar) 100 mg/m² SC once per day on days 1 to 4

14-day cycle for 2 cycles, beginning 2 weeks after completion of EI

References

Tilly H, Mounier N, Lederlin P, Brière J, Dupriez B, Sebban C, Bosly A, Biron P, Nouvel C, Herbrecht R, Bordessoule D, Coiffier B. Randomized comparison of ACVBP and m-BACOD in the treatment of patients with low-risk aggressive lymphoma: the LNH87-1 study. Groupe d'Etudes des Lymphomes de l'Adulte. J Clin Oncol. 2000 Mar;18(6):1309-15. link to original article PubMed
Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A, Attal M, Fillet G, Guettier C, Molina TJ, Gisselbrecht C, Reyes F; Groupe d'Etude des Lymphomes de l'Adulte. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2003 Dec 15;102(13):4284-9. Epub 2003 Aug 14. link to original article contains verified protocol PubMed
Reyes F, Lepage E, Ganem G, Molina TJ, Brice P, Coiffier B, Morel P, Ferme C, Bosly A, Lederlin P, Laurent G, Tilly H; Groupe d'Etude des Lymphomes de l'Adulte (GELA). ACVBP versus CHOP plus radiotherapy for localized aggressive lymphoma. N Engl J Med. 2005 Mar 24;352(12):1197-205. link to original article PubMed
Haioun C, Mounier N, Emile JF, Ranta D, Coiffier B, Tilly H, Récher C, Fermé C, Gabarre J, Herbrecht R, Morchhauser F, Gisselbrecht C. Rituximab versus observation after high-dose consolidative first-line chemotherapy with autologous stem-cell transplantation in patients with poor-risk diffuse large B-cell lymphoma. Ann Oncol. 2009 Dec;20(12):1985-92. Epub 2009 Jun 30. link to original article PubMed
Ketterer N, Coiffier B, Thieblemont C, Fermé C, Brière J, Casasnovas O, Bologna S, Christian B, Connerotte T, Récher C, Bordessoule D, Fruchart C, Delarue R, Bonnet C, Morschhauser F, Anglaret B, Soussain C, Fabiani B, Tilly H, Haioun C. Phase III study of ACVBP versus ACVBP plus rituximab for patients with localized low-risk diffuse large B-cell lymphoma (LNH03-1B). Ann Oncol. 2013 Apr;24(4):1032-7. Epub 2012 Dec 12. link to original article PubMed

CAP-BOP; COP-BLAM

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CAP-BOP: Cyclophosphamide, Adriamycin (Doxorubicin), Procarbazine, Bleomycin, Oncovin (Vincristine), Prednisone
COP-BLAM: Cyclophosphamide, Oncovin (Vincristine), Prednisone, BLeomycin, Adriamycin (Doxorubicin), Matulane (Procarbazine),

Regimen

Study	Evidence
Laurence et al. 1982	Phase II
Armitage et al. 1986	Phase II
Boyd et al. 1988	Phase II
Vose et al. 1988	Phase II

Chemotherapy

References

Laurence J, Coleman M, Allen SL, Silver RT, Pasmantier M. Combination chemotherapy of advanced diffuse histiocytic lymphoma with the six-drug COP-BLAM regimen. Ann Intern Med. 1982 Aug;97(2):190-5. link to original article PubMed
Armitage JO, Weisenburger DD, Hutchins M, Moravec DF, Dowling M, Sorensen S, Mailliard J, Okerbloom J, Johnson PS, Howe D, et al. Chemotherapy for diffuse large-cell lymphoma--rapidly responding patients have more durable remissions. J Clin Oncol. 1986 Feb;4(2):160-4. link to original article PubMed
Boyd DB, Coleman M, Papish SW, Topilow A, Kopel SK, Bernhardt B, Files JC, Schwartz S, Gaynor M, McDermott D, et al. COPBLAM III: infusional combination chemotherapy for diffuse large-cell lymphoma. J Clin Oncol. 1988 Mar;6(3):425-33. link to original article PubMed
Vose JM, Armitage JO, Weisenburger DD, Bierman PJ, Sorensen S, Hutchins M, Moravec DF, Howe D, Dowling MD, Mailliard J, et al. The importance of age in survival of patients treated with chemotherapy for aggressive non-Hodgkin's lymphoma. J Clin Oncol. 1988 Dec;6(12):1838-44. link to original article PubMed

CCOP

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CCOP: Cyclophosphamide, Caelyx (Liposomal Doxorubicin), Oncovin (Vincristine), Prednisone

Regimen

Study	Evidence
Martino et al. 2002	Phase II

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once over 30 minutes on day 1
Doxorubicin liposomal (Doxil) 30 mg/m² IV once over 1 hour on day 1
Vincristine (Oncovin) 2 IV once over 15 minutes on day 1
Prednisone (Sterapred) 60 mg/m² PO once per day on days 1 to 5

21-day cycle for 6 to 8 cycles

References

Martino R, Perea G, Caballero MD, Mateos MV, Ribera JM, de Oteyza JP, Arranz R, Terol MJ, Sierra J, San Miguel JF. Cyclophosphamide, pegylated liposomal doxorubicin (Caelyx), vincristine and prednisone (CCOP) in elderly patients with diffuse large B-cell lymphoma: results from a prospective phase II study. Haematologica. 2002 Aug;87(8):822-7. link to original article contains verified protocol PubMed

CHOEP

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CHOEP: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Etoposide, Prednisone

Synonyms: CHOPE, VACOP

Structured Concept: C9702 (NCI-T), C0212922(NCI-MT/UMLS)

Regimen

Study	Evidence	Comparator	Efficacy	Toxicity
Köppler et al. 1991	Phase III	hCHOP alternating with IVEP
Pfreundschuh et al. 2004 (NHL-B1)	Phase III	CHOP-21 CHOP-14	Seems to have superior EFS	Seems more toxic
Pfreundschuh et al. 2004 (NHL-B2)	Phase III	CHOP-21 CHOP-14	Seems not superior	Seems more toxic

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV once on day 1
Vincristine (Oncovin) 2 mg IV once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5
Etoposide (Vepesid) 100 mg/m² IV once per day on days 1 to 3
Patients with initial bulky disease (mass conglomerate at least 7.5 cm) received 36 Gy radiation therapy and to extranodal sites of disease when possible

Supportive medications

For 14-day cycles: Filgrastim (Neupogen) 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13
Filgrastim (Neupogen) use for 21-day cycles is by discretion of ordering physician

14 or 21-day cycle for 6 cycles, next cycle to start as long as WBC is >2.5 and platelets >80

CHOEP-14 uses 14-day cycles; CHOEP-21 uses 21-day cycles

References

Köppler H, Pflüger KH, Eschenbach I, Pfab R, Birkmann J, Zeller W, Steinhauer EU, Gropp C, Oehl S, Lötzke E, et al. Sequential versus alternating chemotherapy for high grade non-Hodgkin's lymphomas: a randomized multicentre trial. Hematol Oncol. 1991 Jul-Oct;9(4-5):217-23. PubMed
Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rudolph C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B, Rübe C, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):626-33. Epub 2004 Feb 24. link to original article contains verified protocol PubMed
Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):634-41. Epub 2004 Mar 11. link to original article contains verified protocol PubMed
Pfreundschuh M, Trümper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M; MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006 May;7(5):379-91. link to original article PubMed

CHOP

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CHOP: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone

Synonyms: CHOP-21, ACOP, CAVP, COPA, VACP, VCAP

Structured Concept: C9549 (NCI-T), C0055598 (NCI-MT/UMLS)

Regimen #1

Study	Evidence	Comparator	Efficacy
Elias et al. 1978	Non-randomized
Fisher et al. 1993 (SWOG-8516/Intergroup 0067)	Phase III	MACOP-B	Seems not superior
		m-BACOD	Seems not superior
		ProMACE-CytaBOM	Seems not superior
Miller et al. 1998 (SWOG S8736)	Phase III	CHOP x 3 -> RT	Seems to have inferior OS

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV over 15 minutes once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV bolus over 1 to 2 minutes once on day 1
Vincristine (Oncovin) 1.4 mg/m² (maximum dose of 2 mg per cycle) IV bolus over 1 to 2 minutes once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

21-day cycle for 8 cycles

Regimen #2

Study	Evidence	Comparator	Efficacy
Pfreundschuh et al. 2004 (NHL-B1)	Phase III	CHOEP-14 CHOP-14	Seems to have inferior OS
Pfreundschuh et al. 2004 (NHL-B1)	Phase III	CHOEP-21	Inferior EFS
Pfreundschuh et al. 2004 (NHL-B2)	Phase III	CHOEP-14	Seems not superior
		CHOEP-21	Seems not superior
		CHOP-14	Inferior OS
Verdonck et al. 2007	Phase III	I-CHOP	Seems not superior

Treatment in NHL-B1 and NHL-B2 preceded by pre-phase vincristine & prednisone.

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV once on day 1
Vincristine (Oncovin) 2 mg IV once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

Supportive medications

Per NHL-B1 and NHL-B2: At the discretion of ordering physician: Filgrastim (Neupogen) 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13

21-day cycle for 6 cycles

Radiation therapy for initial bulky disease (NHL-B2)

"Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter ≥7.5 cm) or extranodal involvement"

Radiation therapy, 36 Gy to areas of initial bulky disease

Regimen #3, CHOP x 3 -> XRT

Study	Evidence	Comparator	Efficacy
Miller et al. 1998 (SWOG S8736)	Phase III	CHOP x 8	Seems to have superior OS
Reyes et al. 2005	Phase III	ACVBP	Inferior OS

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV over 15 minutes once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV bolus over 1 to 2 minutes once on day 1
Vincristine (Oncovin) 1.4 mg/m² (maximum dose of 2 mg per cycle) IV bolus over 1 to 2 minutes once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

21-day cycle for 3 cycles, followed in 3 weeks by:

Radiotherapy

Involved field radiation therapy, 180 to 200 cGy fractions, total dose of 4000 to 5500 cGy. Total dose was often influenced by whether patients had clinical evidence of residual disease after 4000 cGy.

Regimen #4

Study	Evidence	Comparator	Efficacy
Coiffier et al. 2002 (LNH-98.5)	Phase III	R-CHOP	Inferior OS
Tilly et al. 2003	Phase III	ACVBP	Seems to have inferior OS

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV once on day 1
Vincristine (Oncovin) 1.4 mg/m² (maximum dose of 2 mg per cycle) IV once on day 1
Prednisone (Sterapred) 40 mg/m² PO once per day on days 1 to 5

Supportive medications

Filgrastim (Neupogen) used for later cycles if patients developed grade 4 neutropenia or febrile neutropenia

21-day cycle for 8 cycles

Regimen #5

Study	Evidence	Comparator	Efficacy
Habermann et al. 2006 (CALGB 9793)	Phase III	R-CHOP	Might have inferior FFS

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV once on day 1
Vincristine (Oncovin) 1.4 mg/m² (maximum dose per cycle: 2 mg) IV once on day 1
Prednisone (Sterapred) 100 mg/m² PO once per day on days 1 to 5

Supportive medications

Filgrastim (Neupogen) "recommended according to guidelines"

21-day cycle for 6 to 8 cycles

Patients with CR/PR proceeded to receive maintenance rituximab versus observation.

References

McKelvey EM, Gottlieb JA, Wilson HE, Haut A, Talley RW, Stephens R, Lane M, Gamble JF, Jones SE, Grozea PN, Gutterman J, Coltman C, Moon TE. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer. 1976 Oct;38(4):1484-93. PubMed
Elias L, Portlock CS, Rosenberg SA. Combination chemotherapy of diffuse histiocytic lymphoma with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP). Cancer. 1978 Oct;42(4):1705-10. link to original article contains verified protocol PubMed
Pavlovsky S, Santarelli MT, Erazo A, Diaz Maqueo JC, Somoza N, Lluesma Goñalons M, Cervantes G, Garcia Vela EL, Corrado C, Magnasco H, et al. Results of a randomized study of previously-untreated intermediate and high grade lymphoma using CHOP versus CNOP. Ann Oncol. 1992 Mar;3(3):205-9. link to original article PubMed
Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1002-6. link to original article PubMed
1. Update: Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. A phase III comparison of CHOP vs. m-BACOD vs. ProMACE-CytaBOM vs. MACOP-B in patients with intermediate- or high-grade non-Hodgkin's lymphoma: results of SWOG-8516 (Intergroup 0067), the National High-Priority Lymphoma Study. Ann Oncol. 1994;5 Suppl 2:91-5. PubMed
2. Update: Bernstein SH, Unger JM, Leblanc M, Friedberg J, Miller TP, Fisher RI. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2009 Jan 1;27(1):114-9. Epub 2008 Dec 1. link to original article PubMed
Tondini C, Zanini M, Lombardi F, Bengala C, Rocca A, Giardini R, Buzzoni R, Valagussa P, Bonadonna G. Combined modality treatment with primary CHOP chemotherapy followed by locoregional irradiation in stage I or II histologically aggressive non-Hodgkin's lymphomas. J Clin Oncol. 1993 Apr;11(4):720-5. link to original article PubMed
Miller TP, Dahlberg S, Cassady JR, Adelstein DJ, Spier CM, Grogan TM, LeBlanc M, Carlin S, Chase E, Fisher RI. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma. N Engl J Med. 1998 Jul 2;339(1):21-6. link to original article contains verified protocol PubMed
1. Update: Stephens DM, Li H, LeBlanc ML, Puvvada SD, Persky D, Friedberg JW, Smith SM. Continued Risk of Relapse Independent of Treatment Modality in Limited-Stage Diffuse Large B-Cell Lymphoma: Final and Long-Term Analysis of Southwest Oncology Group Study S8736. J Clin Oncol. 2016 Sep 1;34(25):2997-3004. Epub 2016 Jul 5. link to original article PubMed
Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, Morel P, Van Den Neste E, Salles G, Gaulard P, Reyes F, Lederlin P, Gisselbrecht C. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002 Jan 24;346(4):235-42. link to original article contains verified protocol PubMed
1. Update: Feugier P, Van Hoof A, Sebban C, Solal-Celigny P, Bouabdallah R, Fermé C, Christian B, Lepage E, Tilly H, Morschhauser F, Gaulard P, Salles G, Bosly A, Gisselbrecht C, Reyes F, Coiffier B. Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2005 Jun 20;23(18):4117-26. link to original article contains protocol PubMed
2. Update: Coiffier B, Thieblemont C, Van Den Neste E, Lepeu G, Plantier I, Castaigne S, Lefort S, Marit G, Macro M, Sebban C, Belhadj K, Bordessoule D, Fermé C, Tilly H. Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte. Blood. 2010 Sep 23;116(12):2040-5. link to original article contains verified protocol PubMed
3. Update: Mounier N, Heutte N, Thieblemont C, Briere J, Gaulard P, Feugier P, Ghesquieres H, Van Den Neste E, Robu D, Tilly H, Bouabdallah R, Safar V, Coiffier B; Groupe d'Etude des Lymphomes de l'Adulte (GELA). Ten-year relative survival and causes of death in elderly patients treated with R-CHOP or CHOP in the GELA LNH-985 trial. Clin Lymphoma Myeloma Leuk. 2012 Jun;12(3):151-4. Epub 2012 Feb 1. link to original article PubMed
Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A, Attal M, Fillet G, Guettier C, Molina TJ, Gisselbrecht C, Reyes F; Groupe d'Etude des Lymphomes de l'Adulte. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2003 Dec 15;102(13):4284-9. Epub 2003 Aug 14. link to original article contains verified protocol PubMed
Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rudolph C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B, Rübe C, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):626-33. Epub 2004 Feb 24. link to original article contains verified protocol PubMed
Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):634-41. Epub 2004 Mar 11. link to original article contains verified protocol PubMed
Horning SJ, Weller E, Kim K, Earle JD, O'Connell MJ, Habermann TM, Glick JH. Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma: Eastern Cooperative Oncology Group study 1484. J Clin Oncol. 2004 Aug 1;22(15):3032-8. Epub 2004 Jun 21. link to original article PubMed
Reyes F, Lepage E, Ganem G, Molina TJ, Brice P, Coiffier B, Morel P, Ferme C, Bosly A, Lederlin P, Laurent G, Tilly H; Groupe d'Etude des Lymphomes de l'Adulte (GELA). ACVBP versus CHOP plus radiotherapy for localized aggressive lymphoma. N Engl J Med. 2005 Mar 24;352(12):1197-205. link to original article PubMed
Pfreundschuh M, Trümper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M; MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006 May;7(5):379-91. link to original article contains verified protocol PubMed
1. Update: Pfreundschuh M, Kuhnt E, Trümper L, Osterborg A, Trneny M, Shepherd L, Gill DS, Walewski J, Pettengell R, Jaeger U, Zinzani PL, Shpilberg O, Kvaloy S, de Nully Brown P, Stahel R, Milpied N, López-Guillermo A, Poeschel V, Grass S, Loeffler M, Murawski N; MabThera International Trial (MInT) Group. CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group. Lancet Oncol. 2011 Oct;12(11):1013-22. link to original article contains protocol PubMed
Habermann TM, Weller EA, Morrison VA, Gascoyne RD, Cassileth PA, Cohn JB, Dakhil SR, Woda B, Fisher RI, Peterson BA, Horning SJ. Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma. J Clin Oncol. 2006 Jul 1;24(19):3121-7. Epub 2006 Jun 5. link to original article contains verified protocol PubMed
Bonnet C, Fillet G, Mounier N, Ganem G, Molina TJ, Thiéblemont C, Fermé C, Quesnel B, Martin C, Gisselbrecht C, Tilly H, Reyes F; Groupe d'Etude des Lymphomes de l'Adulte. CHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2007 Mar 1;25(7):787-92. Epub 2007 Jan 16. link to original article contains protocol PubMed
Verdonck LF, Notenboom A, de Jong DD, MacKenzie MA, Verhoef GE, Kramer MH, Ossenkoppele GJ, Doorduijn JK, Sonneveld P, van Imhoff GW. Intensified 12-week CHOP (I-CHOP) plus G-CSF compared with standard 24-week CHOP (CHOP-21) for patients with intermediate-risk aggressive non-Hodgkin lymphoma: a phase 3 trial of the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON). Blood. 2007 Apr 1;109(7):2759-66. link to original article contains verified protocol PubMed

CHOP Intensified

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CHOP-DI: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone, Dose Intense
I-CHOP: Intensified Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone

Synonyms: CHOP-14, CHOP-DI, I-CHOP

Structured Concept: none

Regimen #1

Study	Evidence
Blayney et al. 2003 (CHOP-DI, SWOG 9349)	Phase II

Chemotherapy

Cyclophosphamide (Cytoxan) 1600 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 65 mg/m² IV once on day 1
Vincristine (Oncovin) 1.4 mg/m² IV once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

Supportive medications

Filgrastim (Neupogen) 5 mcg/kg SC once per day on days 2 to 11, or until ANC is greater than 10,000

14-day cycle for up to 6 cycles

Regimen #2

Study	Evidence	Comparator	Efficacy
Verdonck et al. 2007	Phase III	CHOP	Seems not superior

Chemotherapy

Cyclophosphamide (Cytoxan) 1000 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 70 mg/m² IV once on day 1
Vincristine (Oncovin) 2 mg IV once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

Supportive medications

Filgrastim (Neupogen) 5 mcg/kg SC once per day on days 2 to 11

14-day cycle for 6 cycles

Regimen #3

Study	Evidence	Comparator	Efficacy
Pfreundschuh et al. 2004 (NHL-B1)	Phase III	CHOEP-14	Inferior EFS
Pfreundschuh et al. 2004 (NHL-B1)	Phase III	CHOEP-21 CHOP	Seems to have superior OS
Pfreundschuh et al. 2008 (RICOVER-60)	Phase III	CHOP-14 x 8	Seems to have inferior EFS
		R-CHOP-14 x 6	Inferior OS
		R-CHOP-14 x 8	Inferior PFS

Treatment preceded by pre-phase vincristine & prednisone (recommended in NHL-B1 and mandatory in RICOVER-60).

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV once on day 1
Vincristine (Oncovin) 2 mg IV once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

Supportive medications

(per Pfreundschuh et al. 2004):
Filgrastim (Neupogen) 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13

14-day cycle for 6 cycles

Radiation therapy for initial bulky disease

"Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter >=7.5 cm) or extranodal involvement"

Radiation therapy, 36 Gy to areas of initial bulky disease

Regimen #4

Study	Evidence	Comparator	Efficacy
Pfreundschuh et al. 2008 (RICOVER-60)	Phase III	CHOP-14 x 6	Seems to have superior EFS
		R-CHOP-14 x 6	Not reported
		R-CHOP-14 x 8	Not reported

Treatment preceded by pre-phase vincristine & prednisone.

Chemotherapy

Cyclophosphamide (Cytoxan) 750 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 50 mg/m² IV once on day 1
Vincristine (Oncovin) 2 mg IV once on day 1
Prednisone (Sterapred) 100 mg PO once per day on days 1 to 5

Supportive medications

Filgrastim (Neupogen) 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13

14-day cycle for 8 cycles

Radiation therapy for initial bulky disease

"Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter >=7.5 cm) or extranodal involvement"

Radiation therapy, 36 Gy to areas of initial bulky disease

References

Blayney DW, LeBlanc ML, Grogan T, Gaynor ER, Chapman RA, Spiridonidis CH, Taylor SA, Bearman SI, Miller TP, Fisher RI; Southwest Oncology Group. Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma: a phase II study of the Southwest Oncology Group (SWOG 9349). J Clin Oncol. 2003 Jul 1;21(13):2466-73. link to original article contains verified protocol PubMed
Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rudolph C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B, Rübe C, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):626-33. Epub 2004 Feb 24. link to original article contains verified protocol PubMed
Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):634-41. Epub 2004 Mar 11. link to original article PubMed
Verdonck LF, Notenboom A, de Jong DD, MacKenzie MA, Verhoef GE, Kramer MH, Ossenkoppele GJ, Doorduijn JK, Sonneveld P, van Imhoff GW. Intensified 12-week CHOP (I-CHOP) plus G-CSF compared with standard 24-week CHOP (CHOP-21) for patients with intermediate-risk aggressive non-Hodgkin lymphoma: a phase 3 trial of the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON). Blood. 2007 Apr 1;109(7):2759-66. link to original article contains verified protocol PubMed
Pfreundschuh M, Schubert J, Ziepert M, Schmits R, Mohren M, Lengfelder E, Reiser M, Nickenig C, Clemens M, Peter N, Bokemeyer C, Eimermacher H, Ho A, Hoffmann M, Mertelsmann R, Trümper L, Balleisen L, Liersch R, Metzner B, Hartmann F, Glass B, Poeschel V, Schmitz N, Ruebe C, Feller AC, Loeffler M; German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol. 2008 Feb;9(2):105-16. link to original article contains verified protocol PubMed

CHOP Modified

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CHOP: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone

Regimen

Study	Evidence	Comparator	Efficacy
Bessell et al. 2003	Phase III	MCOP	Seems not superior

This regimen is designed for elderly patients and is of lower intensity than standard CHOP.

Chemotherapy

Cyclophosphamide (Cytoxan) 600 mg/m² IV once on day 1
Doxorubicin (Adriamycin) 30 mg/m² IV once on day 1
Vincristine (Oncovin) 1 mg IV once on day 1
Prednisolone (Millipred) 20 mg PO BID on days 1 to 5

21-day cycle for 6 cycles

References

Bessell EM, Burton A, Haynes AP, Glaholm J, Child JA, Cullen MH, Davies JM, Smith GM, Ellis IO, Jack A, Jones EL; Central Lymphoma Group UK. A randomised multicentre trial of modified CHOP versus MCOP in patients aged 65 years and over with aggressive non-Hodgkin's lymphoma. Ann Oncol. 2003 Feb;14(2):258-67. link to original article contains verified protocol PubMed

CHOP-BCG

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CHOP-BCG: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone, Bacillus Calmette-Guérin

Regimen

Study	Evidence	Comparator
Jones et al. 1979	Phase III	CHOP-Bleo
Jones et al. 1979	Phase III	COP-Bleo

Chemotherapy

References

Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Butler JJ, Byrne GE Jr, Moon TE, Fisher R, Haskins CL, Coltman CA Jr. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. contains verified protocol PubMed

CHOP-Bleo

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CHOP-Bleo: Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone, Bleomycin
BACOP: Bleomycin, Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine), Prednisone

Regimen

Study	Evidence	Comparator
Rodriguez et al. 1977	Phase II
Skarin et al. 1977	Phase II
Jones et al. 1979	Phase III	CHOP-BCG
Jones et al. 1979	Phase III	COP-Bleo
Newcomer et al. 1982	Randomized, <20 patients	ACOMLA
Coiffier et al. 1986 (LNH-80)	Phase II
Bajetta et al. 1988	Phase III	CVP

Chemotherapy

References

Rodriguez V, Cabanillas F, Burgess MA, McKelvey EM, Valdivieso M, Bodey GP, Freireich EJ. Combination chemotherapy ("CHOP-Bleo") in advanced (non-Hodgkin) malignant lymphoma. Blood. 1977 Mar;49(3):325-33. link to original article PubMed
Skarin AT, Rosenthal DS, Moloney WC, Frei E 3rd. Combination chemotherapy of advanced non-Hodgkin lymphoma with bleomycin, adriamycin, cyclophosphamide, vincristine, and prednisone (BACOP). Blood. 1977 May;49(5):759-70. link to original article PubMed
Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Butler JJ, Byrne GE Jr, Moon TE, Fisher R, Haskins CL, Coltman CA Jr. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. contains verified protocol PubMed
Newcomer LN, Cadman EC, Nerenberg MI, Chen M, Bertino JR, Farber LR, Prosnitz LR. Randomized study comparing doxorubicin, cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (ACOMLA) with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-B) in the treatment of diffuse histiocytic lymphoma. Cancer Treat Rep. 1982 Jun;66(6):1279-84. PubMed
Coiffier B, Bryon PA, Berger F, Archimbaud E, Ffrench M, Extra JM, Guyotat D, Fiere D, Gentilhomme O, Magaud JP, et al. Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80). J Clin Oncol. 1986 Feb;4(2):147-53. link to original article PubMed
Bajetta E, Valagussa P, Bonadonna G, Lattuada A, Buzzoni R, Rilke F, Banfi A. Combined modality treatment for stage I-II non-Hodgkin's lymphomas: CVP versus BACOP chemotherapy. Int J Radiat Oncol Biol Phys. 1988 Jul;15(1):3-12. link to original article PubMed

C-MOPP

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C-MOPP: CyclophosphaMide, Oncovin (Vincristine), Procarbazine, Prednisone

Regimen

Study	Evidence
DeVita et al. 1975	Phase II

Chemotherapy

References

DeVita VT Jr, Canellos GP, Chabner B, Schein P, Hubbard SP, Young RC. Advanced diffuse histiocytic lymphoma, a potentially curable disease. Lancet. 1975 Feb 1;1(7901):248-50. PubMed]

CNOP; MCOP

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CNOP: Cyclophosphamide, Novantrone (Mitoxantrone), Oncovin (Vincristine), Prednisone
MCOP: Mitoxantrone, Cyclophosphamide, Oncovin (Vincristine), Prednisone

Regimen

Study	Evidence	Comparator	Efficacy
Sonneveld et al. 1990	Phase II
Pavlovsky et al. 1992	Phase III	CHOP	Seems not superior
Bessell et al. 2003	Phase III	Modified CHOP	Seems not superior

Chemotherapy

Cyclophosphamide (Cytoxan) 600 mg/m² IV once on day 1
Mitoxantrone (Novantrone) 10 mg/m² IV once on day 1
Vincristine (Oncovin) 1 mg IV once on day 1
Prednisolone (Millipred) 20 mg PO BID on days 1 to 5

21-day cycle for 6 cycles

References

Sonneveld P, Michiels JJ. Full dose chemotherapy in elderly patients with non-Hodgkin's lymphoma: a feasibility study using a mitoxantrone containing regimen. Br J Cancer. 1990 Jul;62(1):105-8. link to original article PubMed
Pavlovsky S, Santarelli MT, Erazo A, Diaz Maqueo JC, Somoza N, Lluesma Goñalons M, Cervantes G, Garcia Vela EL, Corrado C, Magnasco H, et al. Results of a randomized study of previously-untreated intermediate and high grade lymphoma using CHOP versus CNOP. Ann Oncol. 1992 Mar;3(3):205-9. link to original article PubMed
Bessell EM, Burton A, Haynes AP, Glaholm J, Child JA, Cullen MH, Davies JM, Smith GM, Ellis IO, Jack A, Jones EL; Central Lymphoma Group UK. A randomised multicentre trial of modified CHOP versus MCOP in patients aged 65 years and over with aggressive non-Hodgkin's lymphoma. Ann Oncol. 2003 Feb;14(2):258-67. link to original article contains verified protocol PubMed

COP-Bleo

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COP-Bleo: Cyclophosphamide, Oncovin (Vincristine), Prednisone, Bleomycin

Regimen

Study	Evidence	Comparator
Jones et al. 1979	Phase III	CHOP-BCG
Jones et al. 1979	Phase III	CHOP-Bleo

Chemotherapy

References

Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Butler JJ, Byrne GE Jr, Moon TE, Fisher R, Haskins CL, Coltman CA Jr. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. contains verified protocol PubMed

COPP

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COPP: Cyclophosphamide, Oncovin (Vincristine), Procarbazine, Prednisone

Regimen

Study	Evidence	Comparator
Stein et al. 1974	Phase III	VP

Chemotherapy

Cyclophosphamide (Cytoxan) 500 mg/m² IV drip once per day days 1 & 8
Vincristine (Oncovin) 1.4 mg/m² (maximum of 2 mg per dose) IV once per day on days 1 & 8
Procarbazine (Matulane) 100 mg/m² (maximum of 150 mg per dose) PO once per day on days 1 to 14
Prednisone (Sterapred) 40 mg/m² PO once per day on days 1 to 3, 8 to 10

References

Stein RS, Moran EM, Desser RK, Miller JB, Golomb HM, Ultmann JE. Combination chemotherapy of lymphomas other than Hodgkin's disease. Ann Intern Med. 1974 Nov;81(5):601-8. link to original article PubMed

CVP

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CVP: Cyclophosphamide, Vincristine, Prednisone

Synonyms: COP, COP protocol 2, VCP

Structured Concept: C9573 (NCI-T), C0056633 (NCI-MT/UMLS)

Regimen

Study	Evidence	Comparator
Bagley et al. 1972	Phase II
Monfardini et al. 1977	Phase III	ABP
Bajetta et al. 1988	Phase III	BACOP

Chemotherapy

Cyclophosphamide (Cytoxan) 1000 mg/m² IV once on day 1
Vincristine (Oncovin) 1.4 mg/m² (maximum dose of 2 mg per cycle) IV once on day 1
Prednisone (Sterapred) 100 mg/m² PO once per day on days 1 to 5

21-day cycles

References

Bagley CM Jr, Devita VT Jr, Berard CW, Canellos GP. Advanced lymphosarcoma: intensive cyclical combination chemotherapy with cyclophosphamide, vincristine, and prednisone. Ann Intern Med. 1972 Feb;76(2):227-34. link to original article PubMed
Monfardini S, Tancini G, DeLena M, Villa E, Valagussa P, Bonadonna G. Cyclophosphamide, vincristine, and prednisone (CVP) versus adriamycin, bleomycin, and prednisone (ABP) in stage IV non-Hodgkin's lymphomas. Med Pediatr Oncol. 1977;3(1):67-74. PubMed
Bajetta E, Valagussa P, Bonadonna G, Lattuada A, Buzzoni R, Rilke F, Banfi A. Combined modality treatment for stage I-II non-Hodgkin's lymphomas: CVP versus BACOP chemotherapy. Int J Radiat Oncol Biol Phys. 1988 Jul;15(1):3-12. link to original article PubMed

DA-EPOCH

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DA-EPOCH: Dose Adjusted Etoposide, Prednisone, Oncovin (Vincristine), Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin)

Synonyms: CHEOP

Structured Concept: C63779 (NCI-T), C1880475 (NCI-MT/UMLS)

Regimen

Study	Evidence
Wilson et al. 2002	Phase II

Chemotherapy

Etoposide (Vepesid) 50 mg/m²/day (total dose of 200 mg/m²) IV continuous infusion on days 1 to 4
Prednisone (Sterapred) 60 mg/m² PO BID on days 1 to 5
Vincristine (Oncovin) 0.4 mg/m²/day (total dose of 1.6 mg/m²) IV continuous infusion on days 1 to 4
Cyclophosphamide (Cytoxan) 750 mg/m² IV once over 15 minutes on day 5
Doxorubicin (Adriamycin) 10 mg/m²/day (total dose of 40 mg/m²) IV continuous infusion on days 1 to 4

Supportive medications

Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 6 and continuing until ANC >5,000/uL past nadir
PCP prophylaxis with any one of the following:
- Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg PO BID 3 days per week
- Atovaquone (Mepron) 1500 mg PO once per day
- Pentamidine (Nebupent) 300 mg nebulized every 28 days

21-day cycle for 6 to 8 cycles

Dose-adjustments

Start cycle 1 as described above.
Obtain CBCs twice per week for nadir measurements.
If nadir ANC >500, increase etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
If nadir ANC <500 on 1 or 2 measurements, use same doses as last cycle.
If nadir ANC <500 on at least 3 measurements, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
And/or if nadir platelet count <25 on at least 1 measurement, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
Dose adjustments below the cycle 1 starting dose only applies to cyclophosphamide. The lowest etoposide and doxorubicin would be dosed at is the original cycle 1 dose.
Can start new cycle every 21 days if ANC >1,000 and platelets >100. If counts are below those levels, check daily CBC and continue growth factor support until counts are adequate and next cycle can start.

References

Wilson WH, Grossbard ML, Pittaluga S, Cole D, Pearson D, Drbohlav N, Steinberg SM, Little RF, Janik J, Gutierrez M, Raffeld M, Staudt L, Cheson BD, Longo DL, Harris N, Jaffe ES, Chabner BA, Wittes R, Balis F. Dose-adjusted EPOCH chemotherapy for untreated large B-cell lymphomas: a pharmacodynamic approach with high efficacy. Blood. 2002 Apr 15;99(8):2685-93. link to original article contains verified protocol PubMed

F-MACHOP

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F-MACHOP: Fluorouracil, Methotrexate, Ara-C (Cytarabine), Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone

Regimen

Study	Evidence
Amadori et al. 1985	Non-randomized

Chemotherapy

References

Amadori S, Guglielmi C, Anselmo AP, Cimino G, Ruco LP, Papa G, Biagini C, Mandelli F. Treatment of diffuse aggressive non-Hodgkin's lymphomas with an intensive multi-drug regimen including high-dose cytosine arabinoside (F-MACHOP). Semin Oncol. 1985 Jun;12(2 Suppl 3):218-22. PubMed
1. Update: Guglielmi C, Amadori S, Anselmo AP, Baroni CD, Biagini C, Cimino G, Papa G, Mandelli F. Sequential combination chemotherapy of high-grade non-Hodgkin's lymphoma with 5-fluorouracil, methotrexate, cytosine-arabinoside, cyclophosphamide, doxorubicin, vincristine, and prednisone (F-MACHOP). Cancer Invest. 1987;5(3):159-69. PubMed
2. Update: Guglielmi C, Amadori S, Ruco LP, Mantovani L, Martelli M, Papa G, Mandelli F. Combination chemotherapy for the treatment of diffuse aggressive lymphomas: F-MACHOP update. Semin Oncol. 1987 Jun;14(2 Suppl 1):104-9. PubMed
3. Update: Guglielmi C, Amadori S, Martelli M, Dragoni F, Mandelli F. The F-MACHOP sequential combination chemotherapy regimen in advanced diffuse aggressive lymphomas: long-term results. Ann Oncol. 1991 May;2(5):365-71. link to original article PubMed
Infanti L, Silvestri F, Fanin R, Salmaso F, Zaja F, Barillari G, Patriarca F, Geromin A, Cerno M, Damiani D, Baccarani M. The F-MACHOP regimen in the treatment of aggressive non-Hodgkin's lymphomas: a single center experience in 72 patients. Haematologica. 1996 Nov-Dec;81(6):521-8. link to original article PubMed

HOP

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HOP: Hydroxydaunorubicin (Doxorubicin), Oncovin (Vincristine), Prednisone

Regimen

Study	Evidence	Comparator
McKelvey et al. 1976	Phase III	CHOP

Chemotherapy

References

McKelvey EM, Gottlieb JA, Wilson HE, Haut A, Talley RW, Stephens R, Lane M, Gamble JF, Jones SE, Grozea PN, Gutterman J, Coltman C, Moon TE. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer. 1976 Oct;38(4):1484-93. PubMed

LD-ACOP-B

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LD-ACOP-B: Low-Dose Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine), Prednisone, Bleomycin

Regimen

Study	Evidence
O'Reilly et al. 1991	Non-randomized

Chemotherapy

References

O'Reilly SE, Klimo P, Connors JM. Low-dose ACOP-B and VABE: weekly chemotherapy for elderly patients with advanced-stage diffuse large-cell lymphoma. J Clin Oncol. 1991 May;9(5):741-7. link to original article PubMed

MACOP-B

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MACOP-B: Methotrexate, Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine), Prednisone, Bleomycin

Regimen

Study	Evidence	Comparator
Klimo et al. 1985	Non-randomized
Fisher et al. 1993 (SWOG-8516/Intergroup 0067)	Phase III	CHOP m-BACOD ProMACE-CytaBOM
Sertoli et al. 1994	Phase III	ProMACE-MOPP
Gianni et al. 1997	Phase III	High-dose sequential therapy

Chemotherapy

Methotrexate (MTX) 400 mg/m² IV once per week on weeks 2, 6, 10
Doxorubicin (Adriamycin) 50 mg/m² IV once per week on weeks 1, 3, 5, 7, 9, 11
Cyclophosphamide (Cytoxan) 350 mg/m² IV once per week on weeks 1, 3, 5, 7, 9, 11
Vincristine (Oncovin) 1.4 mg/m² IV once per week on weeks 2, 4, 6, 8, 10, 12
Prednisone (Sterapred) 75 mg PO once per day, tapered over last 15 days (schedule not reported)
Bleomycin (Blenoxane) 10 units/m² IV once per week on weeks 4, 8, 12

CNS prophylaxis (for patients with bone marrow involvement):

Methotrexate (MTX) 12 mg IV

Supportive medications

- Trimethoprim/Sulfamethoxazole (Bactrim DS) 2 tablets (not specified if SS or DS) PO BID

One 12-week course

References

Klimo P, Connors JM. MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma. Ann Intern Med. 1985 May;102(5):596-602. link to original article PubMed
1. Update: Klimo P, Connors JM. Updated clinical experience with MACOP-B. Semin Hematol. 1987 Apr;24(2 Suppl 1):26-34. PubMed
Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1002-6. link to original article PubMed
1. Update: Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. A phase III comparison of CHOP vs. m-BACOD vs. ProMACE-CytaBOM vs. MACOP-B in patients with intermediate- or high-grade non-Hodgkin's lymphoma: results of SWOG-8516 (Intergroup 0067), the National High-Priority Lymphoma Study. Ann Oncol. 1994;5 Suppl 2:91-5. PubMed
2. Update: Bernstein SH, Unger JM, Leblanc M, Friedberg J, Miller TP, Fisher RI. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2009 Jan 1;27(1):114-9. Epub 2008 Dec 1. link to original article PubMed
Sertoli MR, Santini G, Chisesi T, Congiu AM, Rubagotti A, Contu A, Salvagno L, Coser P, Porcellini A, Vespignani M, et al. MACOP-B versus ProMACE-MOPP in the treatment of advanced diffuse non-Hodgkin's lymphoma: results of a prospective randomized trial by the non-Hodgkin's Lymphoma Cooperative Study Group. J Clin Oncol. 1994 Jul;12(7):1366-74. link to original article PubMed
Gianni AM, Bregni M, Siena S, Brambilla C, Di Nicola M, Lombardi F, Gandola L, Tarella C, Pileri A, Ravagnani F, Valagussa P, Bonadonna G. High-dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma. N Engl J Med. 1997 May 1;336(18):1290-7. link to original article PubMed
Pfreundschuh M, Trümper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M; MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006 May;7(5):379-91. link to original article PubMed

m-BACOD

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m-BACOD: methotrexate (moderate dose), Bleomycin, Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine), Dexamethasone

Structured Concept: C63458 (NCI-T), C1883662 (NCI-MT/UMLS)

Regimen

Study	Evidence	Comparator
Skarin et al. 1983	Non-randomized
Guglielmi et al. 1989	Phase III	m-BNCOD
Shipp et al. 1990	Non-randomized
Fisher et al. 1993 (SWOG-8516/Intergroup 0067)	Phase III	CHOP; MACOP-B; ProMACE-CytaBOM
Tilly et al. 2000 (LNH87-1)	Phase III	ACVBP

Chemotherapy

Methotrexate (MTX) 200 mg/m² IV once per day on days 8 & 15
Bleomycin (Blenoxane) 4 units/m² IV once on day 1
Doxorubicin (Adriamycin) 45 mg/m² IV once on day 1
Cyclophosphamide (Cytoxan) 600 mg/m² IV once on day 1
Vincristine (Oncovin) 1 mg/m² (maximum dose of 2 mg per cycle) IV once on day 1
Dexamethasone (Decadron) 6 mg/m² (no route specified) once per day on days 1 to 5

Dose adjustments:

If nadir WBC <1,000 or nadir platelets <50,000: 50% of cyclophosphamide and doxorubicin
If WBC <1,000, platelets <50,000, or creatinine >50% of baseline on day of treatment, methotrexate was omitted

Supportive medications

Folinic acid (Leucovorin) 10 mg/m² PO/IV Q6H x 8 doses, starting 24 hours after Methotrexate (MTX)

21-day cycle for 10 cycles

References

Skarin AT, Canellos GP, Rosenthal DS, Case DC Jr, MacIntyre JM, Pinkus GS, Moloney WC, Frei E 3rd. Improved prognosis of diffuse histiocytic and undifferentiated lymphoma by use of high dose methotrexate alternating with standard agents (M-BACOD). J Clin Oncol. 1983 Feb;1(2):91-8. link to original article PubMed
Guglielmi C, Gherlinzoni F, Amadori S, Mazza P, Mantovani L, Lauria F, Martelli M, Zinzani PL, Greco V, Poletti G, et al. A phase III comparative trial of m-BACOD vs m-BNCOD in the treatment of stage II-IV diffuse non-Hodgkin's lymphomas. Haematologica. 1989 Nov-Dec;74(6):563-9. PubMed
Shipp MA, Yeap BY, Harrington DP, Klatt MM, Pinkus GS, Jochelson MS, Rosenthal DS, Skarin AT, Canellos GP. The m-BACOD combination chemotherapy regimen in large-cell lymphoma: analysis of the completed trial and comparison with the M-BACOD regimen. J Clin Oncol. 1990 Jan;8(1):84-93. link to original article contains verified protocol PubMed
Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1002-6. link to original article PubMed
1. Update: Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. A phase III comparison of CHOP vs. m-BACOD vs. ProMACE-CytaBOM vs. MACOP-B in patients with intermediate- or high-grade non-Hodgkin's lymphoma: results of SWOG-8516 (Intergroup 0067), the National High-Priority Lymphoma Study. Ann Oncol. 1994;5 Suppl 2:91-5. PubMed
2. Update: Bernstein SH, Unger JM, Leblanc M, Friedberg J, Miller TP, Fisher RI. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2009 Jan 1;27(1):114-9. Epub 2008 Dec 1. link to original article PubMed
Tilly H, Mounier N, Lederlin P, Brière J, Dupriez B, Sebban C, Bosly A, Biron P, Nouvel C, Herbrecht R, Bordessoule D, Coiffier B. Randomized comparison of ACVBP and m-BACOD in the treatment of patients with low-risk aggressive lymphoma: the LNH87-1 study. Groupe d'Etudes des Lymphomes de l'Adulte. J Clin Oncol. 2000 Mar;18(6):1309-15. link to original article PubMed

m-BNCOD

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m-BNCOD: methotrexate (moderate dose), Bleomycin, Novantrone (Mitoxantrone), Cyclophosphamide, Oncovin (Vincristine), Dexamethasone

Regimen

Study	Evidence	Comparator
Guglielmi et al. 1989	Phase III	m-BACOD

Chemotherapy

References

Guglielmi C, Gherlinzoni F, Amadori S, Mazza P, Mantovani L, Lauria F, Martelli M, Zinzani PL, Greco V, Poletti G, et al. A phase III comparative trial of m-BACOD vs m-BNCOD in the treatment of stage II-IV diffuse non-Hodgkin's lymphomas. Haematologica. 1989 Nov-Dec;74(6):563-9. PubMed

P/DOCE

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P/DOCE: Prednisone, Doxorubicin, Oncovin (Vincristine), Cyclophosphamide, Etoposide,

Regimen

Study	Evidence
O'Reilly et al. 1993	Phase II

Note that although the drugs are the same as those used in CHOEP, the doses are significantly different and this is intended for elderly persons (65+ years of age).

Chemotherapy

Prednisone (Sterapred) 50 mg/day PO on days 1 to 10, 28 to 37, 49 to 58
Doxorubicin (Adriamycin) 40 mg/m² IV once per week on weeks 1, 2, 7, 8
Vincristine (Oncovin) 1.2 mg/m² IV once per day on days 1, 28, 49
Cyclophosphamide (Cytoxan) 300 mg/m² IV once per day on days 1, 28, 49
Etoposide (Vepesid) 50 mg/m² IV once on day 28, then 100 mg/m² PO once per day on days 29 to 32

8-week course

References

O'Reilly SE, Connors JM, Howdle S, Hoskins P, Klasa R, Klimo P, Stuart DS. In search of an optimal regimen for elderly patients with advanced-stage diffuse large-cell lymphoma: results of a phase II study of P/DOCE chemotherapy. J Clin Oncol. 1993 Nov;11(11):2250-7. link to original article contains verified protocol PubMed

PEN

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PEN: Prednisone, Etoposide, Novantrone (Mitoxantrone)

Regimen

Study	Evidence
Goss et al. 1995	Phase II

Chemotherapy

References

Goss P, Burkes R, Rudinskas L, King M, Chow W, Myers R, Davidson M, Poldre P, Crump M, Sutton D, et al. A phase II trial of prednisone, oral etoposide, and novantrone (PEN) as initial treatment of non-Hodgkin's lymphoma in elderly patients. Leuk Lymphoma. 1995 Jun;18(1-2):145-52. link to original article PubMed

PMitCEBO

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PMitCEBO: Prednisolone, Mitoxantrone, Cyclophosphamide, Etoposide, Bleomycin, Oncovin (Vincristine)

Regimen

Study	Evidence	Comparator	Efficacy
Pfreundschuh et al. 2006 (MInT)	Phase III	R-CHOP R-CHOEP R-MACOP-B R-PMitCEBO	Seems to have inferior EFS

Chemotherapy

References

Burton C, Linch D, Hoskin P, Milligan D, Dyer MJ, Hancock B, Mouncey P, Smith P, Qian W, MacLennan K, Jack A, Webb A, Cunningham D. A phase III trial comparing CHOP to PMitCEBO with or without G-CSF in patients aged 60 plus with aggressive non-Hodgkin's lymphoma. Br J Cancer. 2006 Mar 27;94(6):806-13. link to original article PubMed
Pfreundschuh M, Trümper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M; MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006 May;7(5):379-91. link to original article PubMed

ProMACE-CytaBOM

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ProMACE-CytaBOM: Prolix (Prednisone), Methotrexate, Adriamycin (Doxorubicin), Cyclophosphamide, Etoposide, Cytarabine, Bleomycin, Oncovin (Vincristine), Methotrexate

Structured Concept: C63460 (NCI-T), C1882461 (NCI-MT/UMLS)

Regimen

Study	Evidence	Comparator
Longo et al. 1991	Phase III	ProMACE-MOPP
Fisher et al. 1993 (SWOG-8516/Intergroup 0067)	Phase III	CHOP; MACOP-B; m-BACOD

Chemotherapy

Prednisone (Prolix) 60 mg/m² PO once per day on days 1 to 14
Methotrexate (MTX) 120 mg/m² IV once on day 8
Doxorubicin (Adriamycin) 25 mg/m² IV once on day 1
Cyclophosphamide (Cytoxan) 650 mg/m² IV once on day 1
Etoposide (Vepesid) 120 mg/m² IV once on day 1
Cytarabine (Cytosar) 300 mg/m² IV once on day 8
Bleomycin (Blenoxane) 5 units/m² IV once on day 8
Vincristine (Oncovin) 1.4 mg/m² IV once on day 8

Supportive medications

Folinic acid (Leucovorin) 25 mg/m² PO Q6H x 4 doses, starting 24 hours after Methotrexate (MTX)
Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg PO BID throughout the course of treatment

Dose adjustments

"If WBC is >=4,000, use 100% doses of all drugs
If WBC count is 3,000 to 3,999, 100% prednisone, bleomycin, vincristine, cytarabine, and methotrexate; 75% cyclophosphamide, doxorubicin, and etoposide
If WBC count is 2,000 to 2,999, 100% prednisone, bleomycin, vincristine, and methotrexate; 75% etoposide, cytarabine; 50% cyclophosphamide, doxorubicin
If WBC count is 1,000 to 1,999, 100% prednisone, bleomycin, vincristine and methotrexate; 25% cyclophosphamide, doxorubicin, etoposide, and cytarabine
If WBC count is 0 to 999, 100% prednisone, vincristine, and bleomycin; 50% methotrexate, no other drugs
If platelet count is >=100,000, use 100% doses of all drugs
If platelet count is 50,000 to 99,000, 100% prednisone, bleomycin, vincristine, and methotrexate; 50% etoposide and cytarabine; 25% cyclophosphamide and doxorubicin
If platelet count is 0 to 49,000, 100% prednisone, bleomycin, and vincristine; 50% methotrexate, no other drugs"

21-day cycle for 6 cycles or 2 cycles after maximum clinical response

Patients with initial bone or bone marrow involvement who achieved a CR were treated with 2,400 cGy prophylactic cranial irradiation.

References

Longo DL, DeVita VT Jr, Duffey PL, Wesley MN, Ihde DC, Hubbard SM, Gilliom M, Jaffe ES, Cossman J, Fisher RI et al. Superiority of ProMACE-CytaBOM over ProMACE-MOPP in the treatment of advanced diffuse aggressive lymphoma: results of a prospective randomized trial. J Clin Oncol. 1991 Jan;9(1):25-38. Erratum in: J Clin Oncol 1991 Apr;9(4):710. link to original article contains verified protocol PubMed
Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1002-6. link to original article PubMed
1. Update: Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. A phase III comparison of CHOP vs. m-BACOD vs. ProMACE-CytaBOM vs. MACOP-B in patients with intermediate- or high-grade non-Hodgkin's lymphoma: results of SWOG-8516 (Intergroup 0067), the National High-Priority Lymphoma Study. Ann Oncol. 1994;5 Suppl 2:91-5. PubMed
2. Update: Bernstein SH, Unger JM, Leblanc M, Friedberg J, Miller TP, Fisher RI. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2009 Jan 1;27(1):114-9. Epub 2008 Dec 1. link to original article PubMed

ProMACE-MOPP

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ProMACE-MOPP: Prolix (Prednisone), Methotrexate, Adriamycin (Doxorubicin), Cyclophosphamide, Etoposide, Mustargen (Mechlorethamine), Oncovin (Vincristine), Procarbazine, Prednisone

Regimen

Study	Evidence	Comparator
Longo et al. 1991	Phase III	ProMACE-CytaBOM
Sertoli et al. 1994	Phase III	MACOP-B

Chemotherapy

References

Longo DL, DeVita VT Jr, Duffey PL, Wesley MN, Ihde DC, Hubbard SM, Gilliom M, Jaffe ES, Cossman J, Fisher RI et al. Superiority of ProMACE-CytaBOM over ProMACE-MOPP in the treatment of advanced diffuse aggressive lymphoma: results of a prospective randomized trial. J Clin Oncol. 1991 Jan;9(1):25-38. Erratum in: J Clin Oncol 1991 Apr;9(4):710. link to original article PubMed
Sertoli MR, Santini G, Chisesi T, Congiu AM, Rubagotti A, Contu A, Salvagno L, Coser P, Porcellini A, Vespignani M, et al. MACOP-B versus ProMACE-MOPP in the treatment of advanced diffuse non-Hodgkin's lymphoma: results of a prospective randomized trial by the non-Hodgkin's Lymphoma Cooperative Study Group. J Clin Oncol. 1994 Jul;12(7):1366-74. link to original article PubMed

VABE

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VABE: Vincristine, Adriamycin (Doxorubicin), Bleomycin, Etoposide, Prednisone

Regimen

Study	Evidence
O'Reilly et al. 1991	Non-randomized

Chemotherapy

References

O'Reilly SE, Klimo P, Connors JM. Low-dose ACOP-B and VABE: weekly chemotherapy for elderly patients with advanced-stage diffuse large-cell lymphoma. J Clin Oncol. 1991 May;9(5):741-7. link to original article PubMed

VACOP-B; P-VABEC

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VACOP-B: Vepesid (Etoposide), Adriamycin (Doxorubicin), Cyclophosphamide, Oncovin (Vincristine), Prednisone, Bleomycin
P-VABEC: Prednisone, Vincristine, Adriamycin (Doxorubicin), Bleomycin, Etoposide, Cyclophosphamide

Regimen

Study	Evidence
Pichert et al. 1992	Retrospective
Martelli et al. 1993	Phase II

Chemotherapy

References

Conner JM, Hoskins P, Klasa R et al. VACOP-B: 12-week chemotherapy for advanced stage diffuse large cell lymphoma. Efficacy is sustained and toxicity reduced compared to MACOP-B. Proc Amer Soc Clin Oncol 1990; 9: 254.
Pichert G, Peters J, Stahel RA, Dommann C, Joss R, Gebbers JO, Kroner T, Sulser H, Honegger HP, Maurer R, et al. Chemotherapy with MACOP-B and VACOP-B for intermediate- and high-grade non-Hodgkin's lymphoma: clinical results and analysis of prognostic factors. Ann Oncol. 1992 Sep;3(8):645-9. link to original article PubMed
Martelli M, Guglielmi C, Coluzzi S, Avvisati G, Amadori S, Giovannini M, Torromeo C, Mandelli F. P-VABEC: a prospective study of a new weekly chemotherapy regimen for elderly aggressive non-Hodgkin's lymphoma. J Clin Oncol. 1993 Dec;11(12):2362-9. link to original article PubMed

Relapsed/refractory

DHAP

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DHAP: Dexamethasone, High-dose Ara-C (Cytarabine), Platinol (Cisplatin)

Regimen

Study	Evidence	Comparator	Efficacy
Velasquez et al. 1988	Phase II
Philip et al. 1995 (PARMA)	Phase III	DHAP x 2 -> BEAC	Seems to have inferior OS

Chemotherapy

Dexamethasone (Decadron) 40 mg IV over 15 minutes once per day on days 1 to 4
Cytarabine (Cytosar) as follows:
- Patients younger than 70: 2000 mg/m² IV over 3 hours Q12H x 2 doses on day 2 (total of 2 doses)
- Patients older than 70: 1000 mg/m² IV over 3 hours Q12H x 2 doses on day 2 (total of 2 doses)
Cisplatin (Platinol) 100 mg/m² IV continuous infusion over 24 hours on day 1

Supportive medications

Metoclopramide (Reglan) 1 mg/kg (route and frequency not indicated)
Diphenhydramine (Benadryl) 25 mg IV (frequency not indicated)

3 to 4 week cycle "according to the extent of myelosuppression"

Velasquez et al. 1988 report 6 to 10 courses, usually 4 courses beyond maximum response. The PARMA trial collected bone marrow after cycle 1 and then randomized responders (PR/CR) after cycle 2 to 4 more courses of DHAP versus autologous stem-cell transplant (ASCT).

References

Velasquez WS, Cabanillas F, Salvador P, McLaughlin P, Fridrik M, Tucker S, Jagannath S, Hagemeister FB, Redman JR, Swan F, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988 Jan;71(1):117-22. link to original article contains verified protocol PubMed
Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med. 1995 Dec 7;333(23):1540-5. link to original article does not contain protocol PubMed

DICE

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DICE: Dexamethasone, Ifosfamide, Carboplatin, Etoposide

Regimen

Study	Evidence
Goss et al. 1991	Phase II
Coleman et al. 2001	Phase II

Chemotherapy

References

Goss PE, Shepherd FA, Scott JG, Warner E, Baker MA, Sutton D, Farquharson HA, Buick S, Sutcliffe S. Dexamethasone/ifosfamide/cisplatin/etoposide (DICE) as therapy for patients with advanced refractory non-Hodgkin's lymphoma: preliminary report of a phase II study. Ann Oncol. 1991 Jan;2 Suppl 1:43-6. PubMed
Coleman M, Leonard J, Shuster MW, Kaufman TP. DICE (dexamethasone, ifosfamide, cisplatin, etoposide) infusional chemotherapy for refractory or relapsed non-Hodgkin's lymphoma (NHL). Eur J Haematol Suppl. 2001 Jul;64:41-5. PubMed

DICEP

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DICEP: Dose Intensive, Cyclophosphamide, Etoposide, Platinol (Cisplatin)

Regimen

Study	Evidence
Neidhart et al. 1994	Phase II

Chemotherapy

References

Neidhart JA, Kubica R, Stidley C, Pfile J, Clark D, Rinehart J. Multiple cycles of dose-intensive cyclophosphamide, etoposide, and cisplatinum (DICEP) produce durable responses in refractory non-Hodgkin's lymphoma. Cancer Invest. 1994;12(1):1-11. PubMed

DVIP

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DVIP: Dexamethasone, VP-16 (Etoposide), Ifosfamide, Platinol (Cisplatin)

Regimen

Study	Evidence
Haim et al. 1992	Phase II

Chemotherapy

References

Haim N, Rosenblatt E, Wollner M, Ben-Shahar M, Epelbaum R, Robinson E. Salvage therapy for non-Hodgkin's lymphoma with a combination of dexamethasone, etoposide, ifosfamide, and cisplatin. Cancer Chemother Pharmacol. 1992;30(3):243-4. PubMed

EPIC

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EPIC: Etoposide, Prednisolone, Ifosfamide, Carboplatin

Regimen

Study	Evidence
Hickish et al. 1993	Phase II
Richardson et al. 1994	Phase II, <20 patients

Chemotherapy

References

Hickish T, Roldan A, Cunningham D, Mansi J, Ashley S, Nicolson V, Gore ME, Catovsky D, Smith IE. EPIC: an effective low toxicity regimen for relapsing lymphoma. Br J Cancer. 1993 Sep;68(3):599-604. link to PMC article PubMed
Richardson DS, Tighe M, Cull G, Johnson SA, Phillips MJ. Salvage chemotherapy for relapsed and resistant lymphoma with a carboplatin containing schedule--EPIC. Hematol Oncol. 1994 May-Jun;12(3):125-8. PubMed

EPOCH

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EPOCH: Etoposide, Prednisone, Oncovin, Cyclophosphamide, Hydroxydaunorubicin

Synonyms: CHEOP

Structured Concept: C63779 (NCI-T), C1880475 (NCI-MT/UMLS)

Regimen

Study	Evidence
Wilson et al. 1993	Phase II

Chemotherapy

Etoposide (Vepesid) 50 mg/m²/day (total dose per cycle: 200 mg/m²) IV continuous infusion on days 1 to 4
Prednisone (Sterapred) 60 mg/m² PO on days 1 to 6
Vincristine (Oncovin) 0.4 mg/m²/day (total dose per cycle: 1.6 mg/m²) IV continuous infusion on days 1 to 4
Cyclophosphamide (Cytoxan) 750 mg/m² IV over 15 minutes on day 6
Doxorubicin (Adriamycin) 10 mg/m²/day (total dose per cycle: 40 mg/m²) IV continuous infusion on days 1 to 4

Supportive medications

Filgrastim (Neupogen) 5 mcg/kg SQ once per day, starting on day 6 and continuing until ANC >5,000/uL past nadir
PCP prophylaxis with any one of the following:
- Trimethoprim/Sulfamethoxazole (Bactrim DS) 160/800 mg PO BID 3 days per week
- Atovaquone (Mepron) 1500 mg PO once per day
- Pentamidine (Nebupent) 300 mg nebulized every 28 days

21-day cycle for 6 to 8 cycles

References

Wilson WH, Bryant G, Bates S, Fojo A, Wittes RE, Steinberg SM, Kohler DR, Jaffe ES, Herdt J, Cheson BD et al. EPOCH chemotherapy: toxicity and efficacy in relapsed and refractory non-Hodgkin's lymphoma. J Clin Oncol. 1993 Aug;11(8):1573-82 link to original article contains verified protocol PubMed

ESHA

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ESHA: Etoposide, Solumedrol (Methylprednisolone) High-dose Ara-C (Cytarabine)

Regimen

Study	Evidence	Comparator	Efficacy
Velasquez et al. 1994	Phase III	ESHAP	Inferior RR

Chemotherapy

Etoposide (Vepesid) 40 mg/m² IV over 1 hour once per day on days 1 to 4
Methylprednisolone (Solumedrol) 250 to 500 mg IV over 15 minutes once per day on days 1 to 5
Cytarabine (Cytosar) 2000 mg/m² IV over 2 hours once on day 5

Supportive medications

At least 1 liter normal saline with 25 to 50 g Mannitol once per day throughout chemotherapy
Metoclopramide (Reglan) 0.5 to 1 mg/kg "given regularly"

21 to 28 day cycles ("after recovery of the toxic effects") for 6 to 8 cycles

References

Velasquez WS, McLaughlin P, Tucker S, Hagemeister FB, Swan F, Rodriguez MA, Romaguera J, Rubenstein E, Cabanillas F. ESHAP--an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994 Jun;12(6):1169-76. link to original article contains verified protocol PubMed

ESHAP

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ESHAP: Etoposide, Solumedrol (Methylprednisolone) High-dose Ara-C (Cytarabine), Platinol (Cisplatin)

Regimen

Study	Evidence	Comparator	Efficacy
Velasquez et al. 1994	Phase III	ESHA	Superior RR
Avilés et al. 2010	Phase III	R-ESHAP	Seems not superior

Chemotherapy

Etoposide (Vepesid) 40 mg/m² IV over 1 hour once per day on days 1 to 4
Methylprednisolone (Solumedrol) 250 to 500 mg IV over 15 minutes once per day on days 1 to 5
Cytarabine (Cytosar) 2000 mg/m² IV over 2 hours once on day 5
Cisplatin (Platinol) 25 mg/m²/day IV continuous infusion on days 1 to 4 (total dose per cycle: 100 mg/m²)

Supportive medications

At least 1 liter normal saline with 25 to 50 g Mannitol once per day throughout chemotherapy
Metoclopramide (Reglan) 0.5 to 1 mg/kg "given regularly"

21 to 28 day cycles ("after recovery of the toxic effects") x 6 to 8 cycles

References

Velasquez WS, McLaughlin P, Tucker S, Hagemeister FB, Swan F, Rodriguez MA, Romaguera J, Rubenstein E, Cabanillas F. ESHAP--an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994 Jun;12(6):1169-76. link to original article contains verified protocol PubMed
Avilés A, Neri N, Huerta-Guzmán J, de Jesús Nambo M. ESHAP versus rituximab-ESHAP in frail patients with refractory diffuse large B-cell lymphoma. Clin Lymphoma Myeloma Leuk. 2010 Apr;10(2):125-8. link to original article PubMed

GDP

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GDP: Gemcitabine, Dexamethasone, Platinol (Cisplatin)

Regimen

Study	Evidence
Crump et al. 2004	Phase II

Chemotherapy

Gemcitabine (Gemzar) 1000 mg/m² IV over 30 minutes once per day on days 1 & 8
Dexamethasone (Decadron) 40 mg PO/IV once per day on days 1 to 4
Cisplatin (Platinol) 75 mg/m² IV over 60 minutes once on day 1

21-day cycle for up to 6 cycles

References

Crump M, Baetz T, Couban S, Belch A, Marcellus D, Howson-Jan K, Imrie K, Myers R, Adams G, Ding K, Paul N, Shepherd L, Iglesias J, Meyer R. Gemcitabine, dexamethasone, and cisplatin in patients with recurrent or refractory aggressive histology B-cell non-Hodgkin lymphoma: a Phase II study by the National Cancer Institute of Canada Clinical Trials Group (NCIC-CTG). Cancer. 2004 Oct 15;101(8):1835-42. link to original article PubMed

ICE

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ICE: Ifosfamide, Carboplatin, Etoposide

Regimen

Study	Evidence
Zelenetz et al. 2003	Phase II

Third cycle intended to be followed by peripheral blood hematopoietic cell collection

Chemotherapy

Ifosfamide (Ifex) 5,000 mg/m² IV continuous infusion over 24 hours on day 2, mixed together with Mesna (Mesnex)
Carboplatin (Paraplatin) AUC 5 (maximum dose of 800 mg per cycle) IV bolus once on day 2
- Carboplatin AUC calculated based on a 12-hour creatinine clearance
Etoposide (Vepesid) 100 mg/m² IV bolus once per day on days 1 to 3

14-day cycle for 3 cycles

Supportive medications

Mesna (Mesnex) 5,000 mg/m² IV continuous infusion over 24 hours on day 2, mixed together with Ifosfamide (Ifex)
Filgrastim (Neupogen) 5 µg/kg SC once per day on days 5 to 12 (10 µg/kg with cycle 3, given until collection of peripheral blood hematopoietic cells)

References

Moskowitz CH, Bertino JR, Glassman JR, Hedrick EE, Hunte S, Coady-Lyons N, Agus DB, Goy A, Jurcic J, Noy A, O'Brien J, Portlock CS, Straus DS, Childs B, Frank R, Yahalom J, Filippa D, Louie D, Nimer SD, Zelenetz AD. Ifosfamide, carboplatin, and etoposide: a highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant-eligible patients with non-Hodgkin's lymphoma. J Clin Oncol. 1999 Dec;17(12):3776-85. link to original article PubMed
Zelenetz AD, Hamlin P, Kewalramani T, Yahalom J, Nimer S, Moskowitz CH. Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma. Ann Oncol. 2003;14 Suppl 1:i5-10. link to original article contains verified protocol PubMed
Hertzberg MS, Crombie C, Benson W, Taper J, Gottlieb D, Bradstock KF. Outpatient-based ifosfamide, carboplatin and etoposide (ICE) chemotherapy in transplant-eligible patients with non-Hodgkin's lymphoma and Hodgkin's disease. Ann Oncol. 2003;14 Suppl 1:i11-6. link to original article PubMed

IMVP-16

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IMVP-16: Ifosfamide, Methotrexate, VP-16 (Etoposide)

Regimen

Study	Evidence
Cabanillas et al. 1982	Phase II

Chemotherapy

References

Cabanillas F, Hagemeister FB, Bodey GP, Freireich EJ. IMVP-16: an effective regimen for patients with lymphoma who have relapsed after initial combination chemotherapy. Blood. 1982 Sep;60(3):693-7. link to original article PubMed

MINE-ESHAP

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MINE: Mesna, Ifosfamide, Novantrone (Mitoxantrone), Etoposide
ESHAP: Etoposide, High dose Ara-C (Cytarabine), Platinol (Cisplatin)

Regimen

Study	Evidence
Rodriguez et al. 1995	Phase II

Chemotherapy, MINE portion

Ifosfamide (Ifex) 1.33 g/m² IV over 1 hour once per day on days 1 to 3
Mitoxantrone (Novantrone) 8 g/m² IV once on day 1
Etoposide (Vepesid) 65 mg/m² IV over 1 hour once per day on days 1 to 3

Supportive medications

Mesna (Mesnex) 1.33 g/m² IV over 1 hour once per day on days 1 to 3
Mesna (Mesnex) 500 mg PO once, diluted in water or juice, 4 hours following ifosfamide administration

Chemotherapy, ESHAP portion

Etoposide (Vepesid) 60 mg/m² IV over 1 hour once per day on days 1 to 4
Methylprednisolone (Solumedrol) 500 mg IV as a short infusion once per day on days 1 to 4
Cytarabine (Cytosar) 2000 mg/m² IV over 2 hours once on day 5
Cisplatin (Platinol) 25 mg/m²/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 100 mg/m²)

21-day cycles; patients who achieved a CR received a total of 6 cycles of MINE and then 3 cycles of ESHAP as consolidation therapy. If patients achieved a PR, then MINE was given to the point of maximal response, and then patients were crossed over to ESHAP.

References

Rodriguez MA, Cabanillas FC, Velasquez W, Hagemeister FB, McLaughlin P, Swan F, Romaguera JE. Results of a salvage treatment program for relapsing lymphoma: MINE consolidated with ESHAP. J Clin Oncol. 1995 Jul;13(7):1734-41. link to original article contains verified protocol PubMed

NOAC

back to top

NOAC: NOvantrone (Mitoxantrone), Ara-C (Cytarabine)

Regimen

Study	Evidence
Ho et al. 1989	Phase II

Chemotherapy

References

Ho AD, del Valle F, Rückle H, Schwammborn J, Schlimok G, Hiddemann W, Meusers P, Thiel E, Dörken B, Hunstein W. Mitoxantrone and high-dose cytarabine as salvage therapy for refractory non-Hodgkin's lymphoma. Cancer. 1989 Oct 1;64(7):1388-92. PubMed

VIM

back to top

VIM: Vepesid (Etoposide), Ifosfamide, Mitoxantrone

Regimen

Study	Evidence
Hopfinger et al. 1995	Phase II

Chemotherapy

References

Hopfinger G, Heinz R, Koller E, Schneider B, Pittermann E. Ifosfamide, mitoxantrone and etoposide (VIM) as salvage therapy of low toxicity in non-Hodgkin's lymphoma. Eur J Haematol. 1995 Oct;55(4):223-7. PubMed

@@ Line 31: / Line 31: @@
 |-
 |}
+====Chemotherapy====
+*[[Doxorubicin (Adriamycin)]]
+*[[Bleomycin (Blenoxane)]]
+*[[Prednisone (Sterapred)]]
 ===References===
 # Monfardini S, Tancini G, DeLena M, Villa E, Valagussa P, Bonadonna G. Cyclophosphamide, vincristine, and prednisone (CVP) versus adriamycin, bleomycin, and prednisone (ABP) in stage IV non-Hodgkin's lymphomas. Med Pediatr Oncol. 1977;3(1):67-74. [https://www.ncbi.nlm.nih.gov/pubmed/65728 PubMed]
@@ Line 50: / Line 53: @@
 |[https://www.ncbi.nlm.nih.gov/pubmed/11187906 Dumontet et al. 2000]
 |style="background-color:#EEEE00"|Phase II
-|
+|style="background-color:#d3d3d3"|
 |-
 |[http://annonc.oxfordjournals.org/content/20/12/1985.long Haioun et al. 2009]
@@ Line 57: / Line 60: @@
 |-
 |}
+====Chemotherapy====
+*[[Doxorubicin (Adriamycin)]]
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Etoposide (Vepesid)]]
 ===References===
 # Dumontet C, Thieblemont C, Espinouse D, Bouafia F, Hequet O, Salles G, Coiffier B. A prospective study of intensive induction therapy with high-dose consolidation in patients with aggressive non-Hodgkin's lymphoma and two or three adverse prognostic factors. Leukemia. 2000 Dec;14(12):2159-65. [https://www.ncbi.nlm.nih.gov/pubmed/11187906 PubMed]
@@ Line 76: / Line 82: @@
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/6177407 Newcomer et al. 1982]
-|<span
+|style="background-color:#eeee00"|Randomized, <20 patients
-style="background:#eeee00;
-padding:3px 6px 3px 6px;
-border-color:black;
-border-width:2px;
-border-style:solid;">Randomized, <20 patients</span>
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP-Bleo|CHOP-B]]
 |-
 |}
+====Chemotherapy====
+*[[Doxorubicin (Adriamycin)]]
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Vincristine (Oncovin)]]
+*[[Methotrexate (MTX)]]
+*[[Cytarabine (Cytosar)]]
 ===References===
 # Newcomer LN, Cadman EC, Nerenberg MI, Chen M, Bertino JR, Farber LR, Prosnitz LR. Randomized study comparing doxorubicin, cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (ACOMLA) with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-B) in the treatment of diffuse histiocytic lymphoma. Cancer Treat Rep. 1982 Jun;66(6):1279-84. [https://www.ncbi.nlm.nih.gov/pubmed/6177407 PubMed]
@@ Line 105: / Line 111: @@
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#m-BACOD|m-BACOD]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://www.bloodjournal.org/content/102/13/4284.long Tilly et al. 2003]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP]]
+|[[#CHOP|CHOP]]
 |-
 |[http://www.nejm.org/doi/full/10.1056/NEJMoa042040 Reyes et al. 2005]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP -> RT]]
+|[[#CHOP|CHOP -> RT]]
 |-
 |[http://annonc.oxfordjournals.org/content/20/12/1985.long Haioun et al. 2009]
@@ Line 127: / Line 131: @@
 ====Induction Regimen====
-*[[Doxorubicin (Adriamycin)]] 75 mg/m2 IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 75 mg/m<sup>2</sup> IV once on day 1
-*[[Cyclophosphamide (Cytoxan)]] 1200 mg/m2 IV once on day 1
+*[[Cyclophosphamide (Cytoxan)]] 1200 mg/m<sup>2</sup> IV once on day 1
-*[[Vindesine (Eldisine)]] 2 mg/m2 IV once per day on days 1 & 5
+*[[Vindesine (Eldisine)]] 2 mg/m<sup>2</sup> IV once per day on days 1 & 5
 *[[Bleomycin (Blenoxane)]] 10 units IV once per day on days 1 & 5
-*[[Prednisone (Sterapred)]] 60 mg/m2 PO once per day on days 1 to 5
+*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 5
 CNS prophylaxis:
 *[[Methotrexate (MTX)]] 15 mg intrathecal on day 2
-Supportive medications:
+====Supportive medications====
 *[[:Category:Granulocyte_growth_factors|G-CSF or GM-CSF]] SC once per day on days 6 to 13
-'''21-day cycle x 4 cycles'''
+'''21-day cycle for 4 cycles, followed by:'''
 ====Consolidation Regimen, part 1====
-*[[Methotrexate (MTX)]] 3000 mg/m2 IV once on day 1
+*[[Methotrexate (MTX)]] 3000 mg/m<sup>2</sup> IV once on day 1
-Supportive medications:
+====Supportive medications====
 *[[Folinic acid (Leucovorin)|Leucovorin]] rescue
-'''14-day cycle x 2 cycles''', then
+'''14-day cycle for 2 cycles, followed by:'''
 ====Consolidation Regimen, part 2====
-*[[Etoposide (Vepesid)]] 300 mg/m2 IV once on day 1
+*[[Etoposide (Vepesid)]] 300 mg/m<sup>2</sup> IV once on day 1
-*[[Ifosfamide (Ifex)]] 1500 mg/m2 IV once on day 1
+*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV once on day 1
-Supportive medications:
+====Supportive medications====
 *[[Mesna (Mesnex)]] "protection" (details not provided)
-'''14-day cycle x 4 cycles''', beginning 2 weeks after completion of MTX, then
+'''14-day cycle for 4 cycles''', beginning 2 weeks after completion of MTX, then
 ====Consolidation Regimen, part 3====
-*[[Cytarabine (Cytosar)]] 100 mg/m2 SC once per day on days 1 to 4
+*[[Cytarabine (Cytosar)]] 100 mg/m<sup>2</sup> SC once per day on days 1 to 4
-'''14-day cycle x 2 cycles''', beginning 2 weeks after completion of EI
+'''14-day cycle for 2 cycles''', beginning 2 weeks after completion of EI
 ===References===
@@ Line 170: / Line 174: @@
 # Ketterer N, Coiffier B, Thieblemont C, Fermé C, Brière J, Casasnovas O, Bologna S, Christian B, Connerotte T, Récher C, Bordessoule D, Fruchart C, Delarue R, Bonnet C, Morschhauser F, Anglaret B, Soussain C, Fabiani B, Tilly H, Haioun C. Phase III study of ACVBP versus ACVBP plus rituximab for patients with localized low-risk diffuse large B-cell lymphoma (LNH03-1B). Ann Oncol. 2013 Apr;24(4):1032-7. Epub 2012 Dec 12. [http://annonc.oxfordjournals.org/content/24/4/1032.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/23235801 PubMed]
-==BACOP {{#subobject:cf9aed|Regimen=1}}==
+==CAP-BOP; COP-BLAM {{#subobject:dc0598|Regimen=1}}==
-{| class="wikitable" style="float:right; margin-left: 5px;"
-|-
-|[[#top|back to top]]
-|}
-BACOP: '''<u>B</u>'''leomycin, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
-===Regimen {{#subobject:ed4ec4|Variant=1}}===
-{| border="1" style="text-align:center;" !align="left"
-|'''Study'''
-|[[Levels_of_Evidence#Evidence|'''Evidence''']]
-|'''Comparator'''
-|-
-|[http://www.redjournal.org/article/0360-3016(88)90340-9/abstract Bajetta et al. 1988]
-|style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma_-_obsolete#CVP|CVP]]
-|-
-|}
-===References===
-# Bajetta E, Valagussa P, Bonadonna G, Lattuada A, Buzzoni R, Rilke F, Banfi A. Combined modality treatment for stage I-II non-Hodgkin's lymphomas: CVP versus BACOP chemotherapy. Int J Radiat Oncol Biol Phys. 1988 Jul;15(1):3-12. [http://www.redjournal.org/article/0360-3016(88)90340-9/abstract link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/2455701 PubMed]
-==CAP-BOP, COP-BLAM {{#subobject:dc0598|Regimen=1}}==
 {| class="wikitable" style="float:right; margin-left: 5px;"
 |-
@@ Line 208: / Line 190: @@
 |[http://annals.org/article.aspx?articleid=695798 Laurence et al. 1982]
 |style="background-color:#EEEE00"|Phase II
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/4/2/160.long Armitage et al. 1986]
 |style="background-color:#EEEE00"|Phase II
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/6/3/425.long Boyd et al. 1988]
 |style="background-color:#EEEE00"|Phase II
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/6/12/1838.long Vose et al. 1988]
@@ Line 225: / Line 201: @@
 |-
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Procarbazine (Matulane)]]
+*[[Bleomycin (Blenoxane)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
 ===References===
 # Laurence J, Coleman M, Allen SL, Silver RT, Pasmantier M. Combination chemotherapy of advanced diffuse histiocytic lymphoma with the six-drug COP-BLAM regimen. Ann Intern Med. 1982 Aug;97(2):190-5. [http://annals.org/article.aspx?articleid=695798 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/6179448 PubMed]
@@ Line 248: / Line 230: @@
 |-
 |}
+====Chemotherapy====
-*[[Cyclophosphamide (Cytoxan)]] 750 mg/m2 IV once over 30 minutes on day 1
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once over 30 minutes on day 1
-*[[Doxorubicin liposomal (Doxil)]] 30 mg/m2 IV once over 1 hour on day 1
+*[[Doxorubicin liposomal (Doxil)]] 30 mg/m<sup>2</sup> IV once over 1 hour on day 1
 *[[Vincristine (Oncovin)]] 2 IV once over 15 minutes on day 1
-*[[Prednisone (Sterapred)]] 60 mg/m2 PO once per day on days 1 to 5
+*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 5
-'''21-day cycles x 6 to 8 cycles'''
+'''21-day cycle for 6 to 8 cycles'''
 ===References===
@@ Line 269: / Line 251: @@
 Structured Concept: [http://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary==NCI%20Thesaurus&version==12.09d&code==C9702&key==1863263010&b==1&n==null C9702] (NCI-T), [http://ncim.nci.nih.gov/ncimbrowser/ConceptReport.jsp?dictionary==NCI%20MetaThesaurus&code==C0212922 C0212922](NCI-MT/UMLS)
-===Example orders===
-*[[Example orders for CHOEP in lymphoma]]
 ===Regimen {{#subobject:f61648|Variant=1}}===
@@ Line 284: / Line 263: @@
 |style="background-color:#00CD00"|Phase III
 |hCHOP alternating with IVEP
-|
+|style="background-color:#d3d3d3"|
-|
+|style="background-color:#d3d3d3"|
 |-
 |[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP-21]]<br>[[Diffuse_large_B-cell_lymphoma#CHOP_Intensified|CHOP-14]]
+|[[#CHOP|CHOP-21]]<br>[[#CHOP_Intensified|CHOP-14]]
 |style="background-color:#00CD00"|Seems to have superior EFS
 |style="background-color:#ff0000"|Seems more toxic
@@ Line 295: / Line 274: @@
 |[http://bloodjournal.hematologylibrary.org/content/104/3/634.long Pfreundschuh et al. 2004 (NHL-B2)]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP-21]]<br>[[Diffuse_large_B-cell_lymphoma#CHOP_Intensified|CHOP-14]]
+|[[#CHOP|CHOP-21]]<br>[[#CHOP_Intensified|CHOP-14]]
 |style="background-color:#eeee00"|Seems not superior
 |style="background-color:#ff0000"|Seems more toxic
@@ Line 301: / Line 280: @@
 |}
 ====Chemotherapy====
-*[[Cyclophosphamide (Cytoxan)]] 750 mg/m2 IV once on day 1
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
-*[[Doxorubicin (Adriamycin)]] 50 mg/m2 IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
 *[[Vincristine (Oncovin)]] 2 mg IV once on day 1
 *[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
-*[[Etoposide (Vepesid)]] 100 mg/m2 IV once per day on days 1 to 3
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 1 to 3
 *Patients with initial bulky disease (mass conglomerate at least 7.5 cm) received 36 Gy radiation therapy and to extranodal sites of disease when possible
-Supportive medications:
+====Supportive medications====
 *For 14-day cycles: [[Filgrastim (Neupogen)]] 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13
 *[[Filgrastim (Neupogen)]] use for 21-day cycles is by discretion of ordering physician
-'''14 or 21-day cycles x 6 cycles''', next cycle to start as long as WBC is >2.5 and platelets >80
+'''14 or 21-day cycle for 6 cycles''', next cycle to start as long as WBC is >2.5 and platelets >80
 *CHOEP-14 uses 14-day cycles; CHOEP-21 uses 21-day cycles
@@ Line 320: / Line 299: @@
 # Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):634-41. Epub 2004 Mar 11. [http://bloodjournal.hematologylibrary.org/content/104/3/634.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/15016643 PubMed]
 # Pfreundschuh M, Trümper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M; MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006 May;7(5):379-91. [http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2806%2970664-7/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/16648042 PubMed]
+==CHOP {{#subobject:4ca454|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+CHOP: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
+Synonyms: CHOP-21, ACOP, CAVP, COPA, VACP, VCAP
+Structured Concept: [http://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary==NCI%20Thesaurus&version==12.09d&code==C9549&key==1801231401&b==1&n==null C9549] (NCI-T), [http://ncim.nci.nih.gov/ncimbrowser/ConceptReport.jsp?dictionary==NCI%20MetaThesaurus&code==C0055598 C0055598] (NCI-MT/UMLS)
+===Regimen #1 {{#subobject:256065|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(197810)42:4%3C1705::AID-CNCR2820420408%3E3.0.CO;2-P/abstract Elias et al. 1978]
+|style="background-color:#eeee00"|Non-randomized
+|style="background-color:#d3d3d3"|
+|style="background-color:#d3d3d3"|
+|-
+|rowspan=3|[http://www.nejm.org/doi/full/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
+|rowspan=3 style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#MACOP-B|MACOP-B]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#m-BACOD|m-BACOD]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#ProMACE-CytaBOM|ProMACE-CytaBOM]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|[http://www.nejm.org/doi/full/10.1056/NEJM199807023390104 Miller et al. 1998 (SWOG S8736)]
+|style="background-color:#00cd00"|Phase III
+|CHOP x 3 -> RT
+|style="background-color:#ff0000"|Seems to have inferior OS
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV over 15 minutes once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV bolus over 1 to 2 minutes once on day 1
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg per cycle) IV bolus over 1 to 2 minutes once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+'''21-day cycle for 8 cycles'''
+===Regimen #2 {{#subobject:9e770b|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|rowspan=2|[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
+|rowspan=2 style="background-color:#00cd00"|Phase III
+|CHOEP-14<br> [[#CHOP_Intensified|CHOP-14]]
+|style="background-color:#ff0000"|Seems to have inferior OS
+|-
+|CHOEP-21
+|style="background-color:#ff0000"|Inferior EFS
+|-
+|rowspan=3|[http://www.bloodjournal.org/content/104/3/634.long Pfreundschuh et al. 2004 (NHL-B2)]
+|rowspan=3 style="background-color:#00cd00"|Phase III
+|CHOEP-14
+|style="background-color:#eeee00"|Seems not superior
+|-
+|CHOEP-21
+|style="background-color:#eeee00"|Seems not superior
+|-
+|[[#CHOP_Intensified|CHOP-14]]
+|style="background-color:#ff0000"|Inferior OS
+|-
+|[http://www.bloodjournal.org/content/109/7/2759.long Verdonck et al. 2007]
+|style="background-color:#00cd00"|Phase III
+|[[#CHOP_Intensified|I-CHOP]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|}
+''Treatment in '''NHL-B1''' and '''NHL-B2''' preceded by [[#Vincristine_.26_Prednisone|pre-phase vincristine & prednisone]].''
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 2 mg IV once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+====Supportive medications====
+*Per '''NHL-B1''' and '''NHL-B2''': At the discretion of ordering physician: [[Filgrastim (Neupogen)]] 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13
+'''21-day cycle for 6 cycles'''
+====Radiation therapy for initial bulky disease (NHL-B2)====
+''"Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter ≥7.5 cm) or extranodal involvement"''
+*Radiation therapy, 36 Gy to areas of initial bulky disease
+===Regimen #3, CHOP x 3 -> XRT {{#subobject:503b17|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://www.nejm.org/doi/full/10.1056/NEJM199807023390104 Miller et al. 1998 (SWOG S8736)]
+|style="background-color:#00cd00"|Phase III
+|CHOP x 8
+|style="background-color:#00cd00"|Seems to have superior OS
+|-
+|[http://www.nejm.org/doi/full/10.1056/NEJMoa042040 Reyes et al. 2005]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#ACVBP|ACVBP]]
+|style="background-color:#ff0000"|Inferior OS
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV over 15 minutes once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV bolus over 1 to 2 minutes once on day 1
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg per cycle) IV bolus over 1 to 2 minutes once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+'''21-day cycle for 3 cycles, followed in 3 weeks by:'''
+====Radiotherapy====
+*Involved field radiation therapy, 180 to 200 cGy fractions, total dose of 4000 to 5500 cGy. Total dose was often influenced by whether patients had clinical evidence of residual disease after 4000 cGy.
+===Regimen #4 {{#subobject:9f1357|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://www.nejm.org/doi/full/10.1056/NEJMoa011795 Coiffier et al. 2002 (LNH-98.5)]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]]
+|style="background-color:#ff0000"|Inferior OS
+|-
+|[http://www.bloodjournal.org/content/102/13/4284.long Tilly et al. 2003]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#ACVBP|ACVBP]]
+|style="background-color:#ff0000"|Seems to have inferior OS
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg per cycle) IV once on day 1
+*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 5
+====Supportive medications====
+*[[Filgrastim (Neupogen)]] used for later cycles if patients developed grade 4 neutropenia or febrile neutropenia
+'''21-day cycle for 8 cycles'''
+===Regimen #5 {{#subobject:5b37b5|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://jco.ascopubs.org/content/24/19/3121.long Habermann et al. 2006 (CALGB 9793)]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]]
+|style="background-color:#ff0000"|Might have inferior FFS
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose per cycle: 2 mg) IV once on day 1
+*[[Prednisone (Sterapred)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 5
+====Supportive medications====
+*[[Filgrastim (Neupogen)]] "recommended according to guidelines"
+'''21-day cycle for 6 to 8 cycles'''
+''Patients with CR/PR proceeded to receive [[#Rituximab_.28Rituxan.29|maintenance rituximab]] versus [[#Observation|observation]].''
+===References===
+# McKelvey EM, Gottlieb JA, Wilson HE, Haut A, Talley RW, Stephens R, Lane M, Gamble JF, Jones SE, Grozea PN, Gutterman J, Coltman C, Moon TE. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer. 1976 Oct;38(4):1484-93. [https://www.ncbi.nlm.nih.gov/pubmed/791473 PubMed]
+# Elias L, Portlock CS, Rosenberg SA. Combination chemotherapy of diffuse histiocytic lymphoma with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP). Cancer. 1978 Oct;42(4):1705-10. [http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(197810)42:4%3C1705::AID-CNCR2820420408%3E3.0.CO;2-P/abstract link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/361209 PubMed]
+# Pavlovsky S, Santarelli MT, Erazo A, Diaz Maqueo JC, Somoza N, Lluesma Goñalons M, Cervantes G, Garcia Vela EL, Corrado C, Magnasco H, et al. Results of a randomized study of previously-untreated intermediate and high grade lymphoma using CHOP versus CNOP. Ann Oncol. 1992 Mar;3(3):205-9. [http://annonc.oxfordjournals.org/content/3/3/205.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/1586618 PubMed]
+# Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med. 1993 Apr 8;328(14):1002-6. [http://www.nejm.org/doi/full/10.1056/NEJM199304083281404 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/7680764 PubMed]
+## '''Update:''' Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP. A phase III comparison of CHOP vs. m-BACOD vs. ProMACE-CytaBOM vs. MACOP-B in patients with intermediate- or high-grade non-Hodgkin's lymphoma: results of SWOG-8516 (Intergroup 0067), the National High-Priority Lymphoma Study. Ann Oncol. 1994;5 Suppl 2:91-5. [https://www.ncbi.nlm.nih.gov/pubmed/7515652 PubMed]
+## '''Update:''' Bernstein SH, Unger JM, Leblanc M, Friedberg J, Miller TP, Fisher RI. Natural history of CNS relapse in patients with aggressive non-Hodgkin's lymphoma: a 20-year follow-up analysis of SWOG 8516 -- the Southwest Oncology Group. J Clin Oncol. 2009 Jan 1;27(1):114-9. Epub 2008 Dec 1. [http://jco.ascopubs.org/content/27/1/114.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/19047289 PubMed]
+# Tondini C, Zanini M, Lombardi F, Bengala C, Rocca A, Giardini R, Buzzoni R, Valagussa P, Bonadonna G. Combined modality treatment with primary CHOP chemotherapy followed by locoregional irradiation in stage I or II histologically aggressive non-Hodgkin's lymphomas. J Clin Oncol. 1993 Apr;11(4):720-5. [http://jco.ascopubs.org/content/11/4/720.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/8478665 PubMed]
+# Miller TP, Dahlberg S, Cassady JR, Adelstein DJ, Spier CM, Grogan TM, LeBlanc M, Carlin S, Chase E, Fisher RI. Chemotherapy alone compared with chemotherapy plus radiotherapy for localized intermediate- and high-grade non-Hodgkin's lymphoma. N Engl J Med. 1998 Jul 2;339(1):21-6. [http://www.nejm.org/doi/full/10.1056/NEJM199807023390104 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/9647875 PubMed]
+## '''Update:''' Stephens DM, Li H, LeBlanc ML, Puvvada SD, Persky D, Friedberg JW, Smith SM. Continued Risk of Relapse Independent of Treatment Modality in Limited-Stage Diffuse Large B-Cell Lymphoma: Final and Long-Term Analysis of Southwest Oncology Group Study S8736. J Clin Oncol. 2016 Sep 1;34(25):2997-3004. Epub 2016 Jul 5. [http://jco.ascopubs.org/content/34/25/2997.full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27382104 PubMed]
+# Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, Morel P, Van Den Neste E, Salles G, Gaulard P, Reyes F, Lederlin P, Gisselbrecht C. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med. 2002 Jan 24;346(4):235-42. [http://www.nejm.org/doi/full/10.1056/NEJMoa011795 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/11807147 PubMed]
+## '''Update:''' Feugier P, Van Hoof A, Sebban C, Solal-Celigny P, Bouabdallah R, Fermé C, Christian B, Lepage E, Tilly H, Morschhauser F, Gaulard P, Salles G, Bosly A, Gisselbrecht C, Reyes F, Coiffier B. Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2005 Jun 20;23(18):4117-26. [http://jco.ascopubs.org/content/23/18/4117.full link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/15867204 PubMed]
+## '''Update:''' Coiffier B, Thieblemont C, Van Den Neste E, Lepeu G, Plantier I, Castaigne S, Lefort S, Marit G, Macro M, Sebban C, Belhadj K, Bordessoule D, Fermé C, Tilly H. Long-term outcome of patients in the LNH-98.5 trial, the first randomized study comparing rituximab-CHOP to standard CHOP chemotherapy in DLBCL patients: a study by the Groupe d'Etudes des Lymphomes de l'Adulte. Blood. 2010 Sep 23;116(12):2040-5. [http://www.bloodjournal.org/content/116/12/2040.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20548096 PubMed]
+## '''Update:''' Mounier N, Heutte N, Thieblemont C, Briere J, Gaulard P, Feugier P, Ghesquieres H, Van Den Neste E, Robu D, Tilly H, Bouabdallah R, Safar V, Coiffier B; Groupe d'Etude des Lymphomes de l'Adulte (GELA). Ten-year relative survival and causes of death in elderly patients treated with R-CHOP or CHOP in the GELA LNH-985 trial. Clin Lymphoma Myeloma Leuk. 2012 Jun;12(3):151-4. Epub 2012 Feb 1. [http://www.clinical-lymphoma-myeloma-leukemia.com/article/S2152-2650(11)00607-0/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/22301063 PubMed]
+# Tilly H, Lepage E, Coiffier B, Blanc M, Herbrecht R, Bosly A, Attal M, Fillet G, Guettier C, Molina TJ, Gisselbrecht C, Reyes F; Groupe d'Etude des Lymphomes de l'Adulte. Intensive conventional chemotherapy (ACVBP regimen) compared with standard CHOP for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2003 Dec 15;102(13):4284-9. Epub 2003 Aug 14. [http://www.bloodjournal.org/content/102/13/4284.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/12920037 PubMed]
+# Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rudolph C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B, Rübe C, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):626-33. Epub 2004 Feb 24. [http://www.bloodjournal.org/content/104/3/626.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/14982884 PubMed]
+# Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):634-41. Epub 2004 Mar 11. [http://www.bloodjournal.org/content/104/3/634.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/15016643 PubMed]
+# Horning SJ, Weller E, Kim K, Earle JD, O'Connell MJ, Habermann TM, Glick JH. Chemotherapy with or without radiotherapy in limited-stage diffuse aggressive non-Hodgkin's lymphoma: Eastern Cooperative Oncology Group study 1484. J Clin Oncol. 2004 Aug 1;22(15):3032-8. Epub 2004 Jun 21. [http://jco.ascopubs.org/content/22/15/3032.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15210738 PubMed]
+# Reyes F, Lepage E, Ganem G, Molina TJ, Brice P, Coiffier B, Morel P, Ferme C, Bosly A, Lederlin P, Laurent G, Tilly H; Groupe d'Etude des Lymphomes de l'Adulte (GELA). ACVBP versus CHOP plus radiotherapy for localized aggressive lymphoma. N Engl J Med. 2005 Mar 24;352(12):1197-205. [http://www.nejm.org/doi/full/10.1056/NEJMoa042040 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15788496 PubMed]
+# Pfreundschuh M, Trümper L, Osterborg A, Pettengell R, Trneny M, Imrie K, Ma D, Gill D, Walewski J, Zinzani PL, Stahel R, Kvaloy S, Shpilberg O, Jaeger U, Hansen M, Lehtinen T, López-Guillermo A, Corrado C, Scheliga A, Milpied N, Mendila M, Rashford M, Kuhnt E, Loeffler M; MabThera International Trial Group. CHOP-like chemotherapy plus rituximab versus CHOP-like chemotherapy alone in young patients with good-prognosis diffuse large-B-cell lymphoma: a randomised controlled trial by the MabThera International Trial (MInT) Group. Lancet Oncol. 2006 May;7(5):379-91. [http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2806%2970664-7/fulltext link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16648042 PubMed]
+## '''Update:''' Pfreundschuh M, Kuhnt E, Trümper L, Osterborg A, Trneny M, Shepherd L, Gill DS, Walewski J, Pettengell R, Jaeger U, Zinzani PL, Shpilberg O, Kvaloy S, de Nully Brown P, Stahel R, Milpied N, López-Guillermo A, Poeschel V, Grass S, Loeffler M, Murawski N; MabThera International Trial (MInT) Group. CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group. Lancet Oncol. 2011 Oct;12(11):1013-22. [http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2811%2970235-2/fulltext link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/22118442 PubMed]
+# Habermann TM, Weller EA, Morrison VA, Gascoyne RD, Cassileth PA, Cohn JB, Dakhil SR, Woda B, Fisher RI, Peterson BA, Horning SJ. Rituximab-CHOP versus CHOP alone or with maintenance rituximab in older patients with diffuse large B-cell lymphoma. J Clin Oncol. 2006 Jul 1;24(19):3121-7. Epub 2006 Jun 5. [http://jco.ascopubs.org/content/24/19/3121.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/16754935 PubMed]
+# Bonnet C, Fillet G, Mounier N, Ganem G, Molina TJ, Thiéblemont C, Fermé C, Quesnel B, Martin C, Gisselbrecht C, Tilly H, Reyes F; Groupe d'Etude des Lymphomes de l'Adulte. CHOP alone compared with CHOP plus radiotherapy for localized aggressive lymphoma in elderly patients: a study by the Groupe d'Etude des Lymphomes de l'Adulte. J Clin Oncol. 2007 Mar 1;25(7):787-92. Epub 2007 Jan 16. [http://jco.ascopubs.org/content/25/7/787.long link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/17228021 PubMed]
+<!-- Presented orally and in abstract form at the 47th annual meeting of the American Society of Hematology, Atlanta, Georgia, December 11, 2005. -->
+# Verdonck LF, Notenboom A, de Jong DD, MacKenzie MA, Verhoef GE, Kramer MH, Ossenkoppele GJ, Doorduijn JK, Sonneveld P, van Imhoff GW. Intensified 12-week CHOP (I-CHOP) plus G-CSF compared with standard 24-week CHOP (CHOP-21) for patients with intermediate-risk aggressive non-Hodgkin lymphoma: a phase 3 trial of the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON). Blood. 2007 Apr 1;109(7):2759-66. [http://www.bloodjournal.org/content/109/7/2759.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/17132720 PubMed]
+==CHOP Intensified {{#subobject:6f7a21|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+CHOP-DI: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>D</u>'''ose '''<u>I</u>'''ntense
+<br>I-CHOP: '''<u>I</u>'''ntensified '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
+Synonyms: CHOP-14, CHOP-DI, I-CHOP
+Structured Concept: none
+===Regimen #1 {{#subobject:39e6ac|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|-
+|[http://jco.ascopubs.org/content/21/13/2466.long Blayney et al. 2003 (CHOP-DI, SWOG 9349)]
+|style="background-color:#eeee00"|Phase II
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 1600 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 65 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+====Supportive medications====
+*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day on days 2 to 11, or until ANC is greater than 10,000
+'''14-day cycle for up to 6 cycles'''
+===Regimen #2 {{#subobject:d78eb4|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://www.bloodjournal.org/content/109/7/2759.long Verdonck et al. 2007]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP|CHOP]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 70 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 2 mg IV once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+====Supportive medications====
+*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day on days 2 to 11
+'''14-day cycle for 6 cycles'''
+===Regimen #3 {{#subobject:22ca16|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|rowspan=2|[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
+|rowspan=2 style="background-color:#00cd00"|Phase III
+|CHOEP-14
+|style="background-color:#ff0000"|Inferior EFS
+|-
+|CHOEP-21<br> [[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP|CHOP]]
+|style="background-color:#00cd00"|Seems to have superior OS
+|-
+|rowspan=3|[http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2808%2970002-0/fulltext Pfreundschuh et al. 2008 (RICOVER-60)]
+|rowspan=3 style="background-color:#00cd00"|Phase III
+|CHOP-14 x 8
+|style="background-color:#ff0000"|Seems to have inferior EFS
+|-
+|[[Diffuse_large_B-cell_lymphoma#R-CHOP_Intensified|R-CHOP-14]] x 6
+|style="background-color:#ff0000"|Inferior OS
+|-
+|[[Diffuse_large_B-cell_lymphoma#R-CHOP_Intensified|R-CHOP-14]] x 8
+|style="background-color:#ff0000"|Inferior PFS
+|-
+|}
+''Treatment preceded by [[#Vincristine_.26_Prednisone|pre-phase vincristine & prednisone]] (recommended in '''NHL-B1''' and mandatory in '''RICOVER-60''').''
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 2 mg IV once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+====Supportive medications====
+*(per Pfreundschuh et al. 2004):
+*[[Filgrastim (Neupogen)]] 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13
+'''14-day cycle for 6 cycles'''
+====Radiation therapy for initial bulky disease====
+''"Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter >=7.5 cm) or extranodal involvement"''
+*Radiation therapy, 36 Gy to areas of initial bulky disease
+===Regimen #4 {{#subobject:23cb16|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|rowspan=3|[http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2808%2970002-0/fulltext Pfreundschuh et al. 2008 (RICOVER-60)]
+|rowspan=3 style="background-color:#00cd00"|Phase III
+|CHOP-14 x 6
+|style="background-color:#00cd00"|Seems to have superior EFS
+|-
+|[[Diffuse_large_B-cell_lymphoma#R-CHOP_Intensified|R-CHOP-14]] x 6
+|style="background-color:#d3d3d3"|Not reported
+|-
+|[[Diffuse_large_B-cell_lymphoma#R-CHOP_Intensified|R-CHOP-14]] x 8
+|style="background-color:#d3d3d3"|Not reported
+|-
+|}
+''Treatment preceded by [[#Vincristine_.26_Prednisone|pre-phase vincristine & prednisone]].''
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 2 mg IV once on day 1
+*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
+====Supportive medications====
+*[[Filgrastim (Neupogen)]] 300 mcg (for patients <75 kg) or 480 mcg (for patients at least 75 kg) SC once per day on days 4 to 13
+'''14-day cycle for 8 cycles'''
+====Radiation therapy for initial bulky disease====
+''"Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter >=7.5 cm) or extranodal involvement"''
+*Radiation therapy, 36 Gy to areas of initial bulky disease
+===References===
+# Blayney DW, LeBlanc ML, Grogan T, Gaynor ER, Chapman RA, Spiridonidis CH, Taylor SA, Bearman SI, Miller TP, Fisher RI; Southwest Oncology Group. Dose-intense chemotherapy every 2 weeks with dose-intense cyclophosphamide, doxorubicin, vincristine, and prednisone may improve survival in intermediate- and high-grade lymphoma: a phase II study of the Southwest Oncology Group (SWOG 9349). J Clin Oncol. 2003 Jul 1;21(13):2466-73. [http://jco.ascopubs.org/content/21/13/2466.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/12829664 PubMed]
+# Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rudolph C, Reiser M, Hossfeld DK, Metzner B, Hasenclever D, Schmitz N, Glass B, Rübe C, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of young patients with good-prognosis (normal LDH) aggressive lymphomas: results of the NHL-B1 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):626-33. Epub 2004 Feb 24. [http://www.bloodjournal.org/content/104/3/626.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/14982884 PubMed]
+# Pfreundschuh M, Trümper L, Kloess M, Schmits R, Feller AC, Rübe C, Rudolph C, Reiser M, Hossfeld DK, Eimermacher H, Hasenclever D, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group. Two-weekly or 3-weekly CHOP chemotherapy with or without etoposide for the treatment of elderly patients with aggressive lymphomas: results of the NHL-B2 trial of the DSHNHL. Blood. 2004 Aug 1;104(3):634-41. Epub 2004 Mar 11. [http://www.bloodjournal.org/content/104/3/634.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15016643 PubMed]
+<!-- Presented orally and in abstract form at the 47th annual meeting of the American Society of Hematology, Atlanta, Georgia, December 11, 2005. -->
+# Verdonck LF, Notenboom A, de Jong DD, MacKenzie MA, Verhoef GE, Kramer MH, Ossenkoppele GJ, Doorduijn JK, Sonneveld P, van Imhoff GW. Intensified 12-week CHOP (I-CHOP) plus G-CSF compared with standard 24-week CHOP (CHOP-21) for patients with intermediate-risk aggressive non-Hodgkin lymphoma: a phase 3 trial of the Dutch-Belgian Hemato-Oncology Cooperative Group (HOVON). Blood. 2007 Apr 1;109(7):2759-66. [http://www.bloodjournal.org/content/109/7/2759.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/17132720 PubMed]
+# Pfreundschuh M, Schubert J, Ziepert M, Schmits R, Mohren M, Lengfelder E, Reiser M, Nickenig C, Clemens M, Peter N, Bokemeyer C, Eimermacher H, Ho A, Hoffmann M, Mertelsmann R, Trümper L, Balleisen L, Liersch R, Metzner B, Hartmann F, Glass B, Poeschel V, Schmitz N, Ruebe C, Feller AC, Loeffler M; German High-Grade Non-Hodgkin Lymphoma Study Group (DSHNHL). Six versus eight cycles of bi-weekly CHOP-14 with or without rituximab in elderly patients with aggressive CD20+ B-cell lymphomas: a randomised controlled trial (RICOVER-60). Lancet Oncol. 2008 Feb;9(2):105-16. [http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045%2808%2970002-0/fulltext link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/18226581 PubMed]
+==CHOP Modified {{#subobject:bb947|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+CHOP: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
+===Regimen {{#subobject:4f9502|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://annonc.oxfordjournals.org/content/14/2/258.long Bessell et al. 2003]
+|style="background-color:#00cd00"|Phase III
+|[[#CNOP.2C_MCOP|MCOP]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|}
+''This regimen is designed for elderly patients and is of lower intensity than standard CHOP.''
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 30 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
+*[[Prednisolone (Millipred)]] 20 mg PO BID on days 1 to 5
+'''21-day cycle for 6 cycles'''
+===References===
+# Bessell EM, Burton A, Haynes AP, Glaholm J, Child JA, Cullen MH, Davies JM, Smith GM, Ellis IO, Jack A, Jones EL; Central Lymphoma Group UK. A randomised multicentre trial of modified CHOP versus MCOP in patients aged 65 years and over with aggressive non-Hodgkin's lymphoma. Ann Oncol. 2003 Feb;14(2):258-67. [http://annonc.oxfordjournals.org/content/14/2/258.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/12562653 PubMed]
 ==CHOP-BCG {{#subobject:236052|Regimen=1}}==
@@ Line 337: / Line 697: @@
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP-Bleo|CHOP-Bleo]]
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/84706 Jones et al. 1979]
@@ Line 345: / Line 703: @@
 |-
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
+*[[Bacillus Calmette-Guerin (BCG)]]
 ===References===
 # Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Butler JJ, Byrne GE Jr, Moon TE, Fisher R, Haskins CL, Coltman CA Jr. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/84706 PubMed]
@@ Line 365: / Line 730: @@
 |[http://www.bloodjournal.org/content/49/3/325.long Rodriguez et al. 1977]
 |style="background-color:#EEEE00"|Phase II
-|
+|style="background-color:#d3d3d3"|
-|-
-!colspan="4" align="center"|
 |-
 |[http://www.bloodjournal.org/content/49/5/759.long Skarin et al. 1977]
 |style="background-color:#EEEE00"|Phase II
-|
+|style="background-color:#d3d3d3"|
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/84706 Jones et al. 1979]
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP-BCG|CHOP-BCG]]
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/84706 Jones et al. 1979]
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#COP-Bleo|COP-Bleo]]
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/6177407 Newcomer et al. 1982]
-|<span
+|style="background-color:#eeee00"|Randomized, <20 patients
-style="background:#eeee00;
-padding:3px 6px 3px 6px;
-border-color:black;
-border-width:2px;
-border-style:solid;">Randomized, <20 patients</span>
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#ACOMLA|ACOMLA]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/4/2/147.long Coiffier et al. 1986 (LNH-80)]
 |style="background-color:#EEEE00"|Phase II
-|
+|style="background-color:#d3d3d3"|
+|-
+|[http://www.redjournal.org/article/0360-3016(88)90340-9/abstract Bajetta et al. 1988]
+|style="background-color:#00CD00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#CVP|CVP]]
 |-
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
+*[[Bleomycin (Blenoxane)]]
 ===References===
 # Rodriguez V, Cabanillas F, Burgess MA, McKelvey EM, Valdivieso M, Bodey GP, Freireich EJ. Combination chemotherapy ("CHOP-Bleo") in advanced (non-Hodgkin) malignant lymphoma. Blood. 1977 Mar;49(3):325-33. [http://www.bloodjournal.org/content/49/3/325.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/65189 PubMed]
@@ Line 410: / Line 769: @@
 # Newcomer LN, Cadman EC, Nerenberg MI, Chen M, Bertino JR, Farber LR, Prosnitz LR. Randomized study comparing doxorubicin, cyclophosphamide, vincristine, methotrexate with leucovorin rescue, and cytarabine (ACOMLA) with cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-B) in the treatment of diffuse histiocytic lymphoma. Cancer Treat Rep. 1982 Jun;66(6):1279-84. [https://www.ncbi.nlm.nih.gov/pubmed/6177407 PubMed]
 # Coiffier B, Bryon PA, Berger F, Archimbaud E, Ffrench M, Extra JM, Guyotat D, Fiere D, Gentilhomme O, Magaud JP, et al. Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80). J Clin Oncol. 1986 Feb;4(2):147-53. [http://jco.ascopubs.org/content/4/2/147.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/2418166 PubMed]
+# Bajetta E, Valagussa P, Bonadonna G, Lattuada A, Buzzoni R, Rilke F, Banfi A. Combined modality treatment for stage I-II non-Hodgkin's lymphomas: CVP versus BACOP chemotherapy. Int J Radiat Oncol Biol Phys. 1988 Jul;15(1):3-12. [http://www.redjournal.org/article/0360-3016(88)90340-9/abstract link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/2455701 PubMed]
 ==C-MOPP {{#subobject:5c18a1|Regimen=1}}==
@@ Line 427: / Line 787: @@
 |-
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Vincristine (Oncovin)]]
+*[[Procarbazine (Matulane)]]
+*[[Prednisone (Sterapred)]]
+===References===
+# DeVita VT Jr, Canellos GP, Chabner B, Schein P, Hubbard SP, Young RC. Advanced diffuse histiocytic lymphoma, a potentially curable disease. Lancet. 1975 Feb 1;1(7901):248-50. [https://www.ncbi.nlm.nih.gov/pubmed/46388 PubMed]]
+==CNOP; MCOP {{#subobject:3121b4|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+CNOP: '''<u>C</u>'''yclophosphamide, '''<u>N</u>'''ovantrone (Mitoxantrone), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone<br>
+MCOP: '''<u>M</u>'''itoxantrone, '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
+===Regimen {{#subobject:4a0ab|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1971727/ Sonneveld et al. 1990]
+|style="background-color:#eeee00"|Phase II
+|style="background-color:#d3d3d3"|
+|style="background-color:#d3d3d3"|
+|-
+|[http://annonc.oxfordjournals.org/content/3/3/205.long Pavlovsky et al. 1992]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP|CHOP]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|[http://annonc.oxfordjournals.org/content/14/2/258.long Bessell et al. 2003]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP_Modified|Modified CHOP]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
+*[[Mitoxantrone (Novantrone)]] 10 mg/m<sup>2</sup> IV once on day 1
+*[[Vincristine (Oncovin)]] 1 mg IV once on day 1
+*[[Prednisolone (Millipred)]] 20 mg PO BID on days 1 to 5
+'''21-day cycle for 6 cycles'''
 ===References===
-# DeVita VT Jr, Canellos GP, Chabner B, Schein P, Hubbard SP, Young RC. Advanced diffuse histiocytic lymphoma, a potentially curable disease. Lancet. 1975 Feb 1;1(7901):248-50. [https://www.ncbi.nlm.nih.gov/pubmed/46388 PubMed]]
+# Sonneveld P, Michiels JJ. Full dose chemotherapy in elderly patients with non-Hodgkin's lymphoma: a feasibility study using a mitoxantrone containing regimen. Br J Cancer. 1990 Jul;62(1):105-8. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1971727/ link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/2390469 PubMed]
+# Pavlovsky S, Santarelli MT, Erazo A, Diaz Maqueo JC, Somoza N, Lluesma Goñalons M, Cervantes G, Garcia Vela EL, Corrado C, Magnasco H, et al. Results of a randomized study of previously-untreated intermediate and high grade lymphoma using CHOP versus CNOP. Ann Oncol. 1992 Mar;3(3):205-9. [http://annonc.oxfordjournals.org/content/3/3/205.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/1586618 PubMed]
+# Bessell EM, Burton A, Haynes AP, Glaholm J, Child JA, Cullen MH, Davies JM, Smith GM, Ellis IO, Jack A, Jones EL; Central Lymphoma Group UK. A randomised multicentre trial of modified CHOP versus MCOP in patients aged 65 years and over with aggressive non-Hodgkin's lymphoma. Ann Oncol. 2003 Feb;14(2):258-67. [http://annonc.oxfordjournals.org/content/14/2/258.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/12562653 PubMed]
 ==COP-Bleo {{#subobject:303d31|Regimen=1}}==
@@ Line 447: / Line 855: @@
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#CHOP-BCG|CHOP-BCG]]
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/84706 Jones et al. 1979]
@@ Line 455: / Line 861: @@
 |-
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
+*[[Bleomycin (Blenoxane)]]
 ===References===
 # Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Butler JJ, Byrne GE Jr, Moon TE, Fisher R, Haskins CL, Coltman CA Jr. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/84706 PubMed]
@@ Line 476: / Line 887: @@
 |-
 |}
+====Chemotherapy====
-*[[Cyclophosphamide (Cytoxan)]] 500 mg/m2 IV drip days 1 & 8
+*[[Cyclophosphamide (Cytoxan)]] 500 mg/m<sup>2</sup> IV drip once per day days 1 & 8
-*[[Vincristine (Oncovin)]] 1.4 mg/m2 (maximum of 2 mg per dose) IV once on days 1 & 8
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum of 2 mg per dose) IV once per day on days 1 & 8
-*[[Procarbazine (Matulane)]] 100 mg/m2 (maximum of 150 mg per dose) PO once per day on days 1 to 14
+*[[Procarbazine (Matulane)]] 100 mg/m<sup>2</sup> (maximum of 150 mg per dose) PO once per day on days 1 to 14
-*[[Prednisone (Sterapred)]] 40 mg/m2 PO once per day on days 1 to 3, 8 to 10
+*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 3, 8 to 10
 ===References===
@@ Line 504: / Line 915: @@
 |[http://annals.org/article.aspx?articleid=686149 Bagley et al. 1972]
 |style="background-color:#EEEE00"|Phase II
-|
+|style="background-color:#d3d3d3"|
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/65728 Monfardini et al. 1977]
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#ABP|ABP]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://www.redjournal.org/article/0360-3016(88)90340-9/abstract Bajetta et al. 1988]
@@ Line 519: / Line 926: @@
 |-
 |}
+====Chemotherapy====
-*[[Cyclophosphamide (Cytoxan)]] 1000 mg/m2 IV once on day 1
+*[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV once on day 1
-*[[Vincristine (Oncovin)]] 1.4 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg per cycle) IV once on day 1
-*[[Prednisone (Sterapred)]] 100 mg/m2 PO once per day on days 1 to 5
+*[[Prednisone (Sterapred)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 5
 '''21-day cycles'''
@@ Line 551: / Line 958: @@
 |-
 |}
+====Chemotherapy====
+*[[Etoposide (Vepesid)]] 50 mg/m<sup>2</sup>/day (total dose of 200 mg/m<sup>2</sup>) IV continuous infusion on days 1 to 4
+*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO BID on days 1 to 5
+*[[Vincristine (Oncovin)]] 0.4 mg/m<sup>2</sup>/day (total dose of 1.6 mg/m<sup>2</sup>) IV continuous infusion on days 1 to 4
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once over 15 minutes on day 5
+*[[Doxorubicin (Adriamycin)]] 10 mg/m<sup>2</sup>/day (total dose of 40 mg/m<sup>2</sup>) IV continuous infusion on days 1 to 4
-*[[Etoposide (Vepesid)]] 50 mg/m2/day (total dose of 200 mg/m2) IV continuous infusion on days 1 to 4
+====Supportive medications====
-*[[Prednisone (Sterapred)]] 60 mg/m2 PO BID on days 1 to 5
-*[[Vincristine (Oncovin)]] 0.4 mg/m2/day (total dose of 1.6 mg/m2) IV continuous infusion on days 1 to 4
-*[[Cyclophosphamide (Cytoxan)]] 750 mg/m2 IV once over 15 minutes on day 5
-*[[Doxorubicin (Adriamycin)]] 10 mg/m2/day (total dose of 40 mg/m2) IV continuous infusion on days 1 to 4
-Supportive medications:
 *[[Filgrastim (Neupogen)]] 5 mcg/kg SQ once per day, starting on day 6 and continuing until ANC >5,000/uL past nadir
 *PCP prophylaxis with any one of the following:
@@ Line 565: / Line 972: @@
 **[[Pentamidine (Nebupent)]] 300 mg nebulized every 28 days
-'''21-day cycles x 6 to 8 cycles'''
+'''21-day cycle for 6 to 8 cycles'''
-Dose-adjustments for EPOCH protocol:
+====Dose-adjustments====
 *Start cycle 1 as described above.
 *Obtain CBCs twice per week for nadir measurements.
@@ Line 596: / Line 1,003: @@
 |-
 |}
+====Chemotherapy====
+*[[Fluorouracil (5-FU)]]
+*[[Methotrexate (MTX)]]
+*[[Cytarabine (Cytosar)]]
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
 ===References===
 # Amadori S, Guglielmi C, Anselmo AP, Cimino G, Ruco LP, Papa G, Biagini C, Mandelli F. Treatment of diffuse aggressive non-Hodgkin's lymphomas with an intensive multi-drug regimen including high-dose cytosine arabinoside (F-MACHOP). Semin Oncol. 1985 Jun;12(2 Suppl 3):218-22. [https://www.ncbi.nlm.nih.gov/pubmed/4012340 PubMed]
@@ Line 619: / Line 1,033: @@
 |[https://www.ncbi.nlm.nih.gov/pubmed/791473 McKelvey et al. 1976]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP]]
+|[[#CHOP|CHOP]]
 |-
 |}
+====Chemotherapy====
+*[[Doxorubicin (Adriamycin)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
 ===References===
 # McKelvey EM, Gottlieb JA, Wilson HE, Haut A, Talley RW, Stephens R, Lane M, Gamble JF, Jones SE, Grozea PN, Gutterman J, Coltman C, Moon TE. Hydroxyldaunomycin (Adriamycin) combination chemotherapy in malignant lymphoma. Cancer. 1976 Oct;38(4):1484-93. [https://www.ncbi.nlm.nih.gov/pubmed/791473 PubMed]
@@ Line 642: / Line 1,059: @@
 |
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
+*[[Bleomycin (Blenoxane)]]
 ===References===
 # O'Reilly SE, Klimo P, Connors JM. Low-dose ACOP-B and VABE: weekly chemotherapy for elderly patients with advanced-stage diffuse large-cell lymphoma. J Clin Oncol. 1991 May;9(5):741-7. [http://jco.ascopubs.org/content/9/5/741.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/1707954 PubMed]
@@ Line 665: / Line 1,087: @@
 |[http://www.nejm.org/doi/full/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP]]<br>
+|[[#CHOP|CHOP]]<br>
 [[Diffuse_large_B-cell_lymphoma_-_obsolete#m-BACOD|m-BACOD]]<br>
 [[Diffuse_large_B-cell_lymphoma_-_obsolete#ProMACE-CytaBOM|ProMACE-CytaBOM]]
@@ Line 679: / Line 1,101: @@
 |}
 ====Chemotherapy====
-*[[Methotrexate (MTX)]] 400 mg/m2 IV once per week on weeks 2, 6, 10
+*[[Methotrexate (MTX)]] 400 mg/m<sup>2</sup> IV once per week on weeks 2, 6, 10
-*[[Doxorubicin (Adriamycin)]] 50 mg/m2 IV once per week on weeks 1, 3, 5, 7, 9, 11
+*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once per week on weeks 1, 3, 5, 7, 9, 11
-*[[Cyclophosphamide (Cytoxan)]] 350 mg/m2 IV once per week on weeks 1, 3, 5, 7, 9, 11
+*[[Cyclophosphamide (Cytoxan)]] 350 mg/m<sup>2</sup> IV once per week on weeks 1, 3, 5, 7, 9, 11
-*[[Vincristine (Oncovin)]] 1.4 mg/m2 IV once per week on weeks 2, 4, 6, 8, 10, 12
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once per week on weeks 2, 4, 6, 8, 10, 12
 *[[Prednisone (Sterapred)]] 75 mg PO once per day, tapered over last 15 days (schedule not reported)
-*[[Bleomycin (Blenoxane)]] 10 units/m2 IV once per week on weeks 4, 8, 12
+*[[Bleomycin (Blenoxane)]] 10 units/m<sup>2</sup> IV once per week on weeks 4, 8, 12
 CNS prophylaxis (for patients with bone marrow involvement):
 *[[Methotrexate (MTX)]] 12 mg IV
-Supportive medications:
+====Supportive medications====
 **[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] 2 tablets (not specified if SS or DS) PO BID
@@ Line 721: / Line 1,143: @@
 |[http://jco.ascopubs.org/content/1/2/91.long Skarin et al. 1983]
 |style="background-color:#EEEE00"|Non-randomized
-|
+|style="background-color:#d3d3d3"|
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/2483401 Guglielmi et al. 1989]
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#m-BNCOD|m-BNCOD]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/8/1/84.long Shipp et al. 1990]
 |style="background-color:#EEEE00"|Non-randomized
-|
+|style="background-color:#d3d3d3"|
-|-
-!colspan="4" align="center"|
 |-
 |[http://www.nejm.org/doi/full/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#MACOP-B|MACOP-B]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#ProMACE-CytaBOM|ProMACE-CytaBOM]]
+|[[#CHOP|CHOP]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#MACOP-B|MACOP-B]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#ProMACE-CytaBOM|ProMACE-CytaBOM]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/18/6/1309 Tilly et al. 2000 (LNH87-1)]
@@ Line 748: / Line 1,162: @@
 |-
 |}
+====Chemotherapy====
-*[[Methotrexate (MTX)]] 200 mg/m2 IV once per day on days 8 & 15
+*[[Methotrexate (MTX)]] 200 mg/m<sup>2</sup> IV once per day on days 8 & 15
-*[[Bleomycin (Blenoxane)]] 4 units/m2 IV once on day 1
+*[[Bleomycin (Blenoxane)]] 4 units/m<sup>2</sup> IV once on day 1
-*[[Doxorubicin (Adriamycin)]] 45 mg/m2 IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 45 mg/m<sup>2</sup> IV once on day 1
-*[[Cyclophosphamide (Cytoxan)]] 600 mg/m2 IV once on day 1
+*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
-*[[Vincristine (Oncovin)]] 1 mg/m2 (maximum dose of 2 mg per cycle) IV once on day 1
+*[[Vincristine (Oncovin)]] 1 mg/m<sup>2</sup> (maximum dose of 2 mg per cycle) IV once on day 1
-*[[Dexamethasone (Decadron)]] 6 mg/m2 (no route specified) once per day on days 1 to 5
+*[[Dexamethasone (Decadron)]] 6 mg/m<sup>2</sup> (no route specified) once per day on days 1 to 5
 Dose adjustments:
@@ Line 760: / Line 1,174: @@
 *If WBC <1,000, platelets <50,000, or creatinine >50% of baseline on day of treatment, methotrexate was omitted
-Supportive medications:
+====Supportive medications====
-*[[Folinic acid (Leucovorin)]] 10 mg/m2 PO/IV Q6H x 8 doses, starting 24 hours after [[Methotrexate (MTX)]]
+*[[Folinic acid (Leucovorin)]] 10 mg/m<sup>2</sup> PO/IV Q6H x 8 doses, starting 24 hours after [[Methotrexate (MTX)]]
-'''21-day cycle x 10 cycles'''
+'''21-day cycle for 10 cycles'''
 ===References===
@@ Line 792: / Line 1,206: @@
 |-
 |}
+====Chemotherapy====
+*[[Methotrexate (MTX)]]
+*[[Bleomycin (Blenoxane)]]
+*[[Mitoxantrone (Novantrone)]]
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Vincristine (Oncovin)]]
+*[[Dexamethasonse (Decadron)]]
 ===References===
 # Guglielmi C, Gherlinzoni F, Amadori S, Mazza P, Mantovani L, Lauria F, Martelli M, Zinzani PL, Greco V, Poletti G, et al. A phase III comparative trial of m-BACOD vs m-BNCOD in the treatment of stage II-IV diffuse non-Hodgkin's lymphomas. Haematologica. 1989 Nov-Dec;74(6):563-9. [https://www.ncbi.nlm.nih.gov/pubmed/2483401 PubMed]
@@ Line 812: / Line 1,232: @@
 |-
 |}
 ''Note that although the drugs are the same as those used in CHOEP, the doses are significantly different and this is intended for elderly persons (65+ years of age).''
+====Chemotherapy====
 *[[Prednisone (Sterapred)]] 50 mg/day PO on days 1 to 10, 28 to 37, 49 to 58
-*[[Doxorubicin (Adriamycin)]] 40 mg/m2 IV once per week on weeks 1, 2, 7, 8
+*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once per week on weeks 1, 2, 7, 8
-*[[Vincristine (Oncovin)]] 1.2 mg/m2 IV once per day on days 1, 28, 49
+*[[Vincristine (Oncovin)]] 1.2 mg/m<sup>2</sup> IV once per day on days 1, 28, 49
-*[[Cyclophosphamide (Cytoxan)]] 300 mg/m2 IV once per day on days 1, 28, 49
+*[[Cyclophosphamide (Cytoxan)]] 300 mg/m<sup>2</sup> IV once per day on days 1, 28, 49
-*[[Etoposide (Vepesid)]] 50 mg/m2 IV once on day 28, then 100 mg/m2 PO once per day on days 29 to 32
+*[[Etoposide (Vepesid)]] 50 mg/m<sup>2</sup> IV once on day 28, then 100 mg/m<sup>2</sup> PO once per day on days 29 to 32
 '''8-week course'''
@@ Line 899: / Line 1,318: @@
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#ProMACE-MOPP|ProMACE-MOPP]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://www.nejm.org/doi/full/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#CHOP|CHOP]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#MACOP-B|MACOP-B]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#m-BACOD|m-BACOD]]
+|[[#CHOP|CHOP]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#MACOP-B|MACOP-B]]; [[Diffuse_large_B-cell_lymphoma_-_obsolete#m-BACOD|m-BACOD]]
 |-
 |}
-*[[Prednisone (Sterapred)|Prednisone (Prolix)]] 60 mg/m2 PO once per day on days 1 to 14
+====Chemotherapy====
-*[[Methotrexate (MTX)]] 120 mg/m2 IV once on day 8
+*[[Prednisone (Sterapred)|Prednisone (Prolix)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 14
-*[[Doxorubicin (Adriamycin)]] 25 mg/m2 IV once on day 1
+*[[Methotrexate (MTX)]] 120 mg/m<sup>2</sup> IV once on day 8
-*[[Cyclophosphamide (Cytoxan)]] 650 mg/m2 IV once on day 1
+*[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once on day 1
-*[[Etoposide (Vepesid)]] 120 mg/m2 IV once on day 1
+*[[Cyclophosphamide (Cytoxan)]] 650 mg/m<sup>2</sup> IV once on day 1
-*[[Cytarabine (Cytosar)]] 300 mg/m2 IV once on day 8
+*[[Etoposide (Vepesid)]] 120 mg/m<sup>2</sup> IV once on day 1
-*[[Bleomycin (Blenoxane)]] 5 units/m2 IV once on day 8
+*[[Cytarabine (Cytosar)]] 300 mg/m<sup>2</sup> IV once on day 8
-*[[Vincristine (Oncovin)]] 1.4 mg/m2 IV once on day 8
+*[[Bleomycin (Blenoxane)]] 5 units/m<sup>2</sup> IV once on day 8
+*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 8
-Supportive medications:
+====Supportive medications====
-*[[Folinic acid (Leucovorin)]] 25 mg/m2 PO Q6H x 4 doses, starting 24 hours after [[Methotrexate (MTX)]]
+*[[Folinic acid (Leucovorin)]] 25 mg/m<sup>2</sup> PO Q6H x 4 doses, starting 24 hours after [[Methotrexate (MTX)]]
 *[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO BID throughout the course of treatment
-Dose adjustments:
+====Dose adjustments====
-*"If WBC is =4,000, use 100% doses of all drugs
+*"If WBC is >=4,000, use 100% doses of all drugs
-*If WBC count is 3,000 to 3,999, 100% prednisone, bleomycin, vincristine, cytarabine, and methotrexate; 75% cyclophosphamide, Adriamycin, and etoposide
+*If WBC count is 3,000 to 3,999, 100% prednisone, bleomycin, vincristine, cytarabine, and methotrexate; 75% cyclophosphamide, doxorubicin, and etoposide
-*If WBC count is 2,000 to 2,999, 100% prednisone, bleomycin, vincristine, and methotrexate; 75% etoposide, cytarabine; 50% cyclophosphamide, Adriamycin
+*If WBC count is 2,000 to 2,999, 100% prednisone, bleomycin, vincristine, and methotrexate; 75% etoposide, cytarabine; 50% cyclophosphamide, doxorubicin
-*If WBC count is 1,000 to 1,999, 100% prednisone, bleomycin, vincristine and methotrexate; 25% cyclophosphamide, Adriamycin, etoposide, and cytarabine
+*If WBC count is 1,000 to 1,999, 100% prednisone, bleomycin, vincristine and methotrexate; 25% cyclophosphamide, doxorubicin, etoposide, and cytarabine
 *If WBC count is 0 to 999, 100% prednisone, vincristine, and bleomycin; 50% methotrexate, no other drugs
-*If platelet count is =100,000, use 100% doses of all drugs
+*If platelet count is >=100,000, use 100% doses of all drugs
-*If platelet count is 50,000 to 99,000, 100% prednisone, bleomycin, vincristine, and methotrexate; 50% etoposide and cytarabine; 25% cyclophosphamide and Adriamycin
+*If platelet count is 50,000 to 99,000, 100% prednisone, bleomycin, vincristine, and methotrexate; 50% etoposide and cytarabine; 25% cyclophosphamide and doxorubicin
 *If platelet count is 0 to 49,000, 100% prednisone, bleomycin, and vincristine; 50% methotrexate, no other drugs"
-'''21-day cycle x 6 cycles or 2 cycles after maximum clinical response'''
+'''21-day cycle for 6 cycles or 2 cycles after maximum clinical response'''
 *Patients with initial bone or bone marrow involvement who achieved a CR were treated with 2,400 cGy prophylactic cranial irradiation.
@@ Line 956: / Line 1,374: @@
 |style="background-color:#00CD00"|Phase III
 |[[Diffuse_large_B-cell_lymphoma_-_obsolete#ProMACE-CytaBOM|ProMACE-CytaBOM]]
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/12/7/1366.long Sertoli et al. 1994]
@@ Line 964: / Line 1,380: @@
 |-
 |}
+====Chemotherapy====
+*[[Prednisone (Sterapred)|Prednisone (Prolix)]]
+*[[Methotrexate (MTX)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Etoposide (Vepesid)]]
+*[[Mechlorethamine (Mustargen)]]
+*[[Vincristine (Oncovin)]]
+*[[Procarbazine (Matulane)]]
+*[[Prednisone (Sterapred)]]
 ===References===
 # Longo DL, DeVita VT Jr, Duffey PL, Wesley MN, Ihde DC, Hubbard SM, Gilliom M, Jaffe ES, Cossman J, Fisher RI et al. Superiority of ProMACE-CytaBOM over ProMACE-MOPP in the treatment of advanced diffuse aggressive lymphoma: results of a prospective randomized trial. J Clin Oncol. 1991 Jan;9(1):25-38. Erratum in: J Clin Oncol 1991 Apr;9(4):710. [http://jco.ascopubs.org/content/9/1/25.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/1702144 PubMed]
@@ Line 985: / Line 1,410: @@
 |
 |}
+====Chemotherapy====
+*[[Vincristine (Oncovin)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Bleomycin (Blenoxane)]]
+*[[Etoposide (Vepesid)]]
+*[[Prednisone (Sterapred)]]
 ===References===
 # O'Reilly SE, Klimo P, Connors JM. Low-dose ACOP-B and VABE: weekly chemotherapy for elderly patients with advanced-stage diffuse large-cell lymphoma. J Clin Oncol. 1991 May;9(5):741-7. [http://jco.ascopubs.org/content/9/5/741.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/1707954 PubMed]
@@ Line 1,004: / Line 1,434: @@
 |[http://annonc.oxfordjournals.org/content/3/8/645.long Pichert et al. 1992]
 |style="background-color:#ff0000"|Retrospective
-|-
-!colspan="4" align="center"|
 |-
 |[http://jco.ascopubs.org/content/11/12/2362.long Martelli et al. 1993]
@@ Line 1,011: / Line 1,439: @@
 |-
 |}
+====Chemotherapy====
+*[[Etoposide (Vepesid)]]
+*[[Doxorubicin (Adriamycin)]]
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Vincristine (Oncovin)]]
+*[[Prednisone (Sterapred)]]
+*[[Bleomycin (Blenoxane)]]
 ===References===
 # Conner JM, Hoskins P, Klasa R et al. VACOP-B: 12-week chemotherapy for advanced stage diffuse large cell lymphoma. Efficacy is sustained and toxicity reduced compared to MACOP-B. Proc Amer Soc Clin Oncol 1990; 9: 254.
@@ Line 1,017: / Line 1,452: @@
 =Relapsed/refractory=
+==DHAP {{#subobject:cd4f8f|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+DHAP: '''<u>D</u>'''examethasone, '''<u>H</u>'''igh-dose '''<u>A</u>'''ra-C (Cytarabine), '''<u>P</u>'''latinol (Cisplatin)
+===Regimen {{#subobject:ebcb68|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://www.bloodjournal.org/content/71/1/117 Velasquez et al. 1988]
+|style="background-color:#eeee00"|Phase II
+|style="background-color:#d3d3d3"|
+|style="background-color:#d3d3d3"|
+|-
+|[http://www.nejm.org/doi/full/10.1056/NEJM199512073332305 Philip et al. 1995 (PARMA)]
+|style="background-color:#00cd00"|Phase III
+|[[Transplant_conditioning_regimens#BEAC|DHAP x 2 -> BEAC]]
+|style="background-color:#ff0000"|Seems to have inferior OS
+|-
+|}
+====Chemotherapy====
+*[[Dexamethasone (Decadron)]] 40 mg IV over 15 minutes once per day on days 1 to 4
+*[[Cytarabine (Cytosar)]] as follows:
+**Patients younger than 70: 2000 mg/m<sup>2</sup> IV over 3 hours Q12H x 2 doses on day 2 (total of 2 doses)
+**Patients older than 70: 1000 mg/m<sup>2</sup> IV over 3 hours Q12H x 2 doses on day 2 (total of 2 doses)
+*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV continuous infusion over 24 hours on day 1
+====Supportive medications====
+*[[Metoclopramide (Reglan)]] 1 mg/kg (route and frequency not indicated)
+*[[Diphenhydramine (Benadryl)]] 25 mg IV (frequency not indicated)
+'''3 to 4 week cycle "according to the extent of myelosuppression"'''
+'''''Velasquez et al. 1988''' report 6 to 10 courses, usually 4 courses beyond maximum response. The '''PARMA''' trial collected bone marrow after cycle 1 and then randomized responders (PR/CR) after cycle 2 to 4 more courses of DHAP versus [[Diffuse_large_B-cell_lymphoma#Autologous_hematopoietic_cell_transplant|autologous stem-cell transplant (ASCT)]].''
+===References===
+# Velasquez WS, Cabanillas F, Salvador P, McLaughlin P, Fridrik M, Tucker S, Jagannath S, Hagemeister FB, Redman JR, Swan F, et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood. 1988 Jan;71(1):117-22. [http://www.bloodjournal.org/content/71/1/117 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/3334893 PubMed]
+# Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med. 1995 Dec 7;333(23):1540-5. [http://www.nejm.org/doi/full/10.1056/NEJM199512073332305 link to original article] '''does not contain protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/7477169 PubMed]
 ==DICE {{#subobject:deaf96|Regimen=1}}==
@@ Line 1,032: / Line 1,511: @@
 |[https://www.ncbi.nlm.nih.gov/pubmed/2043497 Goss et al. 1991]
 |style="background-color:#EEEE00"|Phase II
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/11486401 Coleman et al. 2001]
@@ Line 1,039: / Line 1,516: @@
 |-
 |}
+====Chemotherapy====
+*[[Dexamethasone (Decadron)]]
+*[[Ifosfamide (Ifex)]]
+*[[Carboplatin (Paraplatin)]]
+*[[Etoposide (Vepesid)]]
 ===References===
 # Goss PE, Shepherd FA, Scott JG, Warner E, Baker MA, Sutton D, Farquharson HA, Buick S, Sutcliffe S. Dexamethasone/ifosfamide/cisplatin/etoposide (DICE) as therapy for patients with advanced refractory non-Hodgkin's lymphoma: preliminary report of a phase II study. Ann Oncol. 1991 Jan;2 Suppl 1:43-6. [https://www.ncbi.nlm.nih.gov/pubmed/2043497 PubMed]
@@ Line 1,060: / Line 1,541: @@
 |-
 |}
+====Chemotherapy====
+*[[Cyclophosphamide (Cytoxan)]]
+*[[Etoposide (Vepesid)]]
+*[[Cisplatin (Platinol)]]
 ===References===
 #Neidhart JA, Kubica R, Stidley C, Pfile J, Clark D, Rinehart J. Multiple cycles of dose-intensive cyclophosphamide, etoposide, and cisplatinum (DICEP) produce durable responses in refractory non-Hodgkin's lymphoma. Cancer Invest. 1994;12(1):1-11. [https://www.ncbi.nlm.nih.gov/pubmed/8281458 PubMed]
@@ Line 1,080: / Line 1,564: @@
 |-
 |}
+====Chemotherapy====
+*[[Dexamethasone (Decadron)]]
+*[[Etoposide (Vepesid)]]
+*[[Ifosfamide (Ifex)]]
+*[[Cisplatin (Platinol)]]
 ===References===
 # Haim N, Rosenblatt E, Wollner M, Ben-Shahar M, Epelbaum R, Robinson E. Salvage therapy for non-Hodgkin's lymphoma with a combination of dexamethasone, etoposide, ifosfamide, and cisplatin. Cancer Chemother Pharmacol. 1992;30(3):243-4. [https://www.ncbi.nlm.nih.gov/pubmed/1628376 PubMed]
@@ Line 1,098: / Line 1,586: @@
 |[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1968387/ Hickish et al. 1993]
 |style="background-color:#EEEE00"|Phase II
-|-
-!colspan="4" align="center"|
 |-
 |[https://www.ncbi.nlm.nih.gov/pubmed/7959640 Richardson et al. 1994]
-|<span
+|style="background-color:#ff0000"|Phase II, <20 patients
-style="background:#ff0000;
-padding:3px 6px 3px 6px;
-border-color:black;
-border-width:2px;
-border-style:solid;">Phase II, <20 patients</span>
 |-
 |}
+====Chemotherapy====
+*[[Etoposide (Vepesid)]]
+*[[Predinsolone (Millipred)]]
+*[[Ifosfamide (Ifex)]]
+*[[Carboplatin (Paraplatin)]]
 ===References===
 # Hickish T, Roldan A, Cunningham D, Mansi J, Ashley S, Nicolson V, Gore ME, Catovsky D, Smith IE. EPIC: an effective low toxicity regimen for relapsing lymphoma. Br J Cancer. 1993 Sep;68(3):599-604. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1968387/ link to PMC article] [https://www.ncbi.nlm.nih.gov/pubmed/8353050 PubMed]
 # Richardson DS, Tighe M, Cull G, Johnson SA, Phillips MJ. Salvage chemotherapy for relapsed and resistant lymphoma with a carboplatin containing schedule--EPIC. Hematol Oncol. 1994 May-Jun;12(3):125-8. [https://www.ncbi.nlm.nih.gov/pubmed/7959640 PubMed]
+==EPOCH {{#subobject:eca645|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+EPOCH: '''<u>E</u>'''toposide, '''<u>P</u>'''rednisone, '''<u>O</u>'''ncovin, '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin
+Synonyms: CHEOP
+Structured Concept: [http://ncit.nci.nih.gov/ncitbrowser/ConceptReport.jsp?dictionary==NCI%20Thesaurus&version==12.09d&code==C63779 C63779] (NCI-T), [http://ncim.nci.nih.gov/ncimbrowser/ConceptReport.jsp?dictionary==NCI%20MetaThesaurus&code==C1880475 C1880475] (NCI-MT/UMLS)
+===Regimen {{#subobject:492bdc|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|-
+|[http://jco.ascopubs.org/content/11/8/1573.long Wilson et al. 1993]
+|style="background-color:#eeee00"|Phase II
+|-
+|}
+====Chemotherapy====
+*[[Etoposide (Vepesid)]] 50 mg/m<sup>2</sup>/day (total dose per cycle: 200 mg/m<sup>2</sup>) IV continuous infusion on days 1 to 4
+*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO on days 1 to 6
+*[[Vincristine (Oncovin)]] 0.4 mg/m<sup>2</sup>/day (total dose per cycle: 1.6 mg/m<sup>2</sup>) IV continuous infusion on days 1 to 4
+*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV over 15 minutes on day 6
+*[[Doxorubicin (Adriamycin)]] 10 mg/m<sup>2</sup>/day (total dose per cycle: 40 mg/m<sup>2</sup>) IV continuous infusion on days 1 to 4
+====Supportive medications====
+*[[Filgrastim (Neupogen)]] 5 mcg/kg SQ once per day, starting on day 6 and continuing until ANC >5,000/uL past nadir
+*PCP prophylaxis with any one of the following:
+**[[Trimethoprim/Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO BID 3 days per week
+**[[Atovaquone (Mepron)]] 1500 mg PO once per day
+**[[Pentamidine (Nebupent)]] 300 mg nebulized every 28 days
+'''21-day cycle for 6 to 8 cycles'''
+===References===
+# Wilson WH, Bryant G, Bates S, Fojo A, Wittes RE, Steinberg SM, Kohler DR, Jaffe ES, Herdt J, Cheson BD et al. EPOCH chemotherapy: toxicity and efficacy in relapsed and refractory non-Hodgkin's lymphoma. J Clin Oncol. 1993 Aug;11(8):1573-82 [http://jco.ascopubs.org/content/11/8/1573.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/7687667 PubMed]
 ==ESHA {{#subobject:e26b69|Regimen=1}}==
@@ Line 1,131: / Line 1,655: @@
 |[http://jco.ascopubs.org/content/12/6/1169.long Velasquez et al. 1994]
 |style="background-color:#00CD00"|Phase III
-|[[Diffuse_large_B-cell_lymphoma#ESHAP|ESHAP]]
+|[[#ESHAP|ESHAP]]
-|<span
+|style="background-color:#ff0000"|Inferior RR
-style="background:#ff0000;
+|-
-padding:3px 6px 3px 6px;
+|}
-border-color:black;
+====Chemotherapy====
-border-width:2px;
+*[[Etoposide (Vepesid)]] 40 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 to 4
-border-style:solid;">Inferior RR</span>
+*[[Methylprednisolone (Solumedrol)]] 250 to 500 mg IV over 15 minutes once per day on days 1 to 5
+*[[Cytarabine (Cytosar)]] 2000 mg/m<sup>2</sup> IV over 2 hours once on day 5
+====Supportive medications====
+*At least 1 liter normal saline with 25 to 50 g [[Mannitol]] once per day throughout chemotherapy
+*[[Metoclopramide (Reglan)]] 0.5 to 1 mg/kg "given regularly"
+'''21 to 28 day cycles ("after recovery of the toxic effects") for 6 to 8 cycles'''
+===References===
+# Velasquez WS, McLaughlin P, Tucker S, Hagemeister FB, Swan F, Rodriguez MA, Romaguera J, Rubenstein E, Cabanillas F. ESHAP--an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994 Jun;12(6):1169-76. [http://jco.ascopubs.org/content/12/6/1169.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/8201379 PubMed]
+==ESHAP {{#subobject:4c0082|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
 |-
+|[[#top|back to top]]
 |}
+ESHAP: '''<u>E</u>'''toposide, '''<u>S</u>'''olumedrol (Methylprednisolone) '''<u>H</u>'''igh-dose '''<u>A</u>'''ra-C (Cytarabine), '''<u>P</u>'''latinol (Cisplatin)
-*[[Etoposide (Vepesid)]] 40 mg/m2 IV over 1 hour once per day on days 1 to 4
+===Regimen {{#subobject:ae8823|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|'''Comparator'''
+|[[Levels_of_Evidence#Efficacy|'''Efficacy''']]
+|-
+|[http://jco.ascopubs.org/content/12/6/1169.long Velasquez et al. 1994]
+|style="background-color:#00cd00"|Phase III
+|[[#ESHA|ESHA]]
+|style="background-color:#00cd00"|Superior RR
+|-
+|[http://www.clinical-lymphoma-myeloma-leukemia.com/article/S2152-2650(11)70097-0/fulltext Avilés et al. 2010]
+|style="background-color:#00cd00"|Phase III
+|[[Diffuse_large_B-cell_lymphoma#R-ESHAP|R-ESHAP]]
+|style="background-color:#eeee00"|Seems not superior
+|-
+|}
+====Chemotherapy====
+*[[Etoposide (Vepesid)]] 40 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 to 4
 *[[Methylprednisolone (Solumedrol)]] 250 to 500 mg IV over 15 minutes once per day on days 1 to 5
-*[[Cytarabine (Cytosar)]] 2000 mg/m2 IV over 2 hours once on day 5
+*[[Cytarabine (Cytosar)]] 2000 mg/m<sup>2</sup> IV over 2 hours once on day 5
+*[[Cisplatin (Platinol)]] 25 mg/m<sup>2</sup>/day IV continuous infusion on days 1 to 4 (total dose per cycle: 100 mg/m<sup>2</sup>)
-Supportive medications:
+====Supportive medications====
 *At least 1 liter normal saline with 25 to 50 g [[Mannitol]] once per day throughout chemotherapy
 *[[Metoclopramide (Reglan)]] 0.5 to 1 mg/kg "given regularly"
@@ Line 1,153: / Line 1,712: @@
 ===References===
 # Velasquez WS, McLaughlin P, Tucker S, Hagemeister FB, Swan F, Rodriguez MA, Romaguera J, Rubenstein E, Cabanillas F. ESHAP--an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol. 1994 Jun;12(6):1169-76. [http://jco.ascopubs.org/content/12/6/1169.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/8201379 PubMed]
+# Avilés A, Neri N, Huerta-Guzmán J, de Jesús Nambo M. ESHAP versus rituximab-ESHAP in frail patients with refractory diffuse large B-cell lymphoma. Clin Lymphoma Myeloma Leuk. 2010 Apr;10(2):125-8. [http://www.clinical-lymphoma-myeloma-leukemia.com/article/S2152-2650(11)70097-0/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/20371445 PubMed]
 ==GDP {{#subobject:20e899|Regimen=1}}==
@@ Line 1,170: / Line 1,730: @@
 |-
 |}
+====Chemotherapy====
-*[[Gemcitabine (Gemzar)]] 1000 mg/m2 IV over 30 minutes once per day on days 1 & 8
+*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
 *[[Dexamethasone (Decadron)]] 40 mg PO/IV once per day on days 1 to 4
-*[[Cisplatin (Platinol)]] 75 mg/m2 IV over 60 minutes once on day 1
+*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV over 60 minutes once on day 1
-'''21-day cycle x up to 6 cycles'''
+'''21-day cycle for up to 6 cycles'''
 ===References===
 # Crump M, Baetz T, Couban S, Belch A, Marcellus D, Howson-Jan K, Imrie K, Myers R, Adams G, Ding K, Paul N, Shepherd L, Iglesias J, Meyer R. Gemcitabine, dexamethasone, and cisplatin in patients with recurrent or refractory aggressive histology B-cell non-Hodgkin lymphoma: a Phase II study by the National Cancer Institute of Canada Clinical Trials Group (NCIC-CTG). Cancer. 2004 Oct 15;101(8):1835-42. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.20587/full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15386331 PubMed]
+==ICE {{#subobject:f535c2|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[#top|back to top]]
+|}
+ICE: '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>E</u>'''toposide
+===Regimen {{#subobject:d573d9|Variant=1}}===
+{| border="1" style="text-align:center;" !align="left"
+|'''Study'''
+|[[Levels_of_Evidence#Evidence|'''Evidence''']]
+|-
+|[http://annonc.oxfordjournals.org/content/14/suppl_1/i5.long Zelenetz et al. 2003]
+|style="background-color:#eeee00"|Phase II
+|-
+|}
+''Third cycle intended to be followed by peripheral blood hematopoietic cell collection''
+====Chemotherapy====
+*[[Ifosfamide (Ifex)]] 5,000 mg/m<sup>2</sup> IV continuous infusion over 24 hours on day 2, mixed together with [[Mesna (Mesnex)]]
+*[[Carboplatin (Paraplatin)]] AUC 5 (maximum dose of 800 mg per cycle) IV bolus once on day 2
+**Carboplatin AUC calculated based on a 12-hour creatinine clearance
+*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV bolus once per day on days 1 to 3
+'''14-day cycle for 3 cycles'''
+====Supportive medications====
+*[[Mesna (Mesnex)]] 5,000 mg/m<sup>2</sup> IV continuous infusion over 24 hours on day 2, mixed together with [[Ifosfamide (Ifex)]]
+*[[Filgrastim (Neupogen)]] 5 µg/kg SC once per day on days 5 to 12 (10 µg/kg with cycle 3, given until collection of peripheral blood hematopoietic cells)
+===References===
+# Moskowitz CH, Bertino JR, Glassman JR, Hedrick EE, Hunte S, Coady-Lyons N, Agus DB, Goy A, Jurcic J, Noy A, O'Brien J, Portlock CS, Straus DS, Childs B, Frank R, Yahalom J, Filippa D, Louie D, Nimer SD, Zelenetz AD. Ifosfamide, carboplatin, and etoposide: a highly effective cytoreduction and peripheral-blood progenitor-cell mobilization regimen for transplant-eligible patients with non-Hodgkin's lymphoma. J Clin Oncol. 1999 Dec;17(12):3776-85. [http://jco.ascopubs.org/content/17/12/3776.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/10577849 PubMed]
+# Zelenetz AD, Hamlin P, Kewalramani T, Yahalom J, Nimer S, Moskowitz CH. Ifosfamide, carboplatin, etoposide (ICE)-based second-line chemotherapy for the management of relapsed and refractory aggressive non-Hodgkin's lymphoma. Ann Oncol. 2003;14 Suppl 1:i5-10. [http://annonc.oxfordjournals.org/content/14/suppl_1/i5.long link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/12736224 PubMed]
+# Hertzberg MS, Crombie C, Benson W, Taper J, Gottlieb D, Bradstock KF. Outpatient-based ifosfamide, carboplatin and etoposide (ICE) chemotherapy in transplant-eligible patients with non-Hodgkin's lymphoma and Hodgkin's disease. Ann Oncol. 2003;14 Suppl 1:i11-6. [http://annonc.oxfordjournals.org/content/14/suppl_1/i11.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/12736225 PubMed]
 ==IMVP-16 {{#subobject:d49400|Regimen=1}}==
@@ Line 1,196: / Line 1,791: @@
 |-
 |}
+====Chemotherapy====
 *[[Ifosfamide (Ifex)]]
 *[[Methotrexate (MTX)]]
@@ Line 1,220: / Line 1,816: @@
 |-
 |}
+====Chemotherapy, MINE portion====
+*[[Ifosfamide (Ifex)]] 1.33 g/m<sup>2</sup> IV over 1 hour once per day on days 1 to 3
+*[[Mitoxantrone (Novantrone)]] 8 g/m<sup>2</sup> IV once on day 1
+*[[Etoposide (Vepesid)]] 65 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 to 3
-====Part 1: MINE====
+====Supportive medications====
-*[[Ifosfamide (Ifex)]] 1.33 g/m2 IV over 1 hour once per day on days 1 to 3
+*[[Mesna (Mesnex)]] 1.33 g/m<sup>2</sup> IV over 1 hour once per day on days 1 to 3
-*[[Mitoxantrone (Novantrone)]] 8 g/m2 IV once on day 1
-*[[Etoposide (Vepesid)]] 65 mg/m2 IV over 1 hour once per day on days 1 to 3
-Supportive medications:
-*[[Mesna (Mesnex)]] 1.33 g/m2 IV over 1 hour once per day on days 1 to 3
 *[[Mesna (Mesnex)]] 500 mg PO once, diluted in water or juice, 4 hours following ifosfamide administration
-====Part 2: ESHAP====
+====Chemotherapy, ESHAP portion====
-*[[Etoposide (Vepesid)]] 60 mg/m2 IV over 1 hour once per day on days 1 to 4
+*[[Etoposide (Vepesid)]] 60 mg/m<sup>2</sup> IV over 1 hour once per day on days 1 to 4
 *[[Methylprednisolone (Solumedrol)]] 500 mg IV as a short infusion once per day on days 1 to 4
-*[[Cytarabine (Cytosar)]] 2000 mg/m2 IV over 2 hours once on day 5
+*[[Cytarabine (Cytosar)]] 2000 mg/m<sup>2</sup> IV over 2 hours once on day 5
-*[[Cisplatin (Platinol)]] 25 mg/m2/day IV continuous infusion over 96 hours (total dose per cycle: 100 mg/m2) on days 1 to 4
+*[[Cisplatin (Platinol)]] 25 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours on days 1 to 4 (total dose per cycle: 100 mg/m<sup>2</sup>)
 '''21-day cycles; patients who achieved a CR received a total of 6 cycles of MINE and then 3 cycles of ESHAP as consolidation therapy. If patients achieved a PR, then MINE was given to the point of maximal response, and then patients were crossed over to ESHAP.'''
@@ Line 1,257: / Line 1,852: @@
 |-
 |}
+====Chemotherapy====
+*[[Mitoxantrone (Novantrone)]]
+*[[Cytarabine (Cytosar)]]
 ===References===
 # Ho AD, del Valle F, Rückle H, Schwammborn J, Schlimok G, Hiddemann W, Meusers P, Thiel E, Dörken B, Hunstein W. Mitoxantrone and high-dose cytarabine as salvage therapy for refractory non-Hodgkin's lymphoma. Cancer. 1989 Oct 1;64(7):1388-92. [https://www.ncbi.nlm.nih.gov/pubmed/2776103 PubMed]
@@ Line 1,277: / Line 1,874: @@
 |-
 |}
+====Chemotherapy====
+*[[Etoposide (Vepesid)]]
+*[[Ifosfamide (Ifex)]]
+*[[Mitoxantrone (Novantrone)]]
 ===References===
 # Hopfinger G, Heinz R, Koller E, Schneider B, Pittermann E. Ifosfamide, mitoxantrone and etoposide (VIM) as salvage therapy of low toxicity in non-Hodgkin's lymphoma. Eur J Haematol. 1995 Oct;55(4):223-7. [https://www.ncbi.nlm.nih.gov/pubmed/7589338 PubMed]
+[[Category:Chemotherapy regimens]]
+[[Category:Malignant hematology regimens]]
+[[Category:Lymphoma regimens]]
+[[Category:Obsolete regimens]]

Difference between revisions of "Diffuse large B-cell lymphoma - historical"

Revision as of 01:09, 12 March 2017

Untreated

ABP

Regimen

Chemotherapy

References

ACE

Regimen

Chemotherapy

References

ACOMLA

Regimen

Chemotherapy

References

ACVBP

Regimen

Induction Regimen

Supportive medications

Consolidation Regimen, part 1

Supportive medications

Consolidation Regimen, part 2

Supportive medications

Consolidation Regimen, part 3

References

CAP-BOP; COP-BLAM

Regimen

Chemotherapy

References

CCOP

Regimen

Chemotherapy

References

CHOEP

Regimen

Chemotherapy

Supportive medications

References

CHOP

Regimen #1

Chemotherapy

Regimen #2

Chemotherapy

Supportive medications

Radiation therapy for initial bulky disease (NHL-B2)

Regimen #3, CHOP x 3 -> XRT

Chemotherapy

Radiotherapy

Regimen #4

Chemotherapy

Supportive medications

Regimen #5

Chemotherapy

Supportive medications

References

CHOP Intensified

Regimen #1

Chemotherapy

Supportive medications

Regimen #2

Chemotherapy

Supportive medications

Regimen #3

Chemotherapy

Supportive medications

Radiation therapy for initial bulky disease

Regimen #4

Chemotherapy

Supportive medications

Radiation therapy for initial bulky disease

References

CHOP Modified

Regimen

Chemotherapy

References

CHOP-BCG

Regimen

Chemotherapy

References

CHOP-Bleo