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The purpose of this page is to provide references to regimens that are obsolete, outdated, or of historical interest only.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 [http://www.nccn.org/professionals/physician_gls/f_guidelines.asp NCCN Guidelines]. Is there a regimen missing from this list? See the [[Diffuse_large_B-cell_lymphoma|main DLBCL page]] for current regimens.
 
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{| class="wikitable" style="float:right; margin-right: 5px;"
 
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|-
 
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|<div style="background-color: #fee0d1; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}" align="right"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Regimen |limit=10000|format=sum}} [[Tutorial#Regimens|regimens]] on this page</b></font></div>
 
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<div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]]  |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 
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|}
 
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{{TOC limit|limit=3}}
 
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=Untreated=
 
−
==ABP {{#subobject:cefeba|Regimen=1}}==
 
−
ABP: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:04855a|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1002/mpo.2950030110 Monfardini et al. 1977]
 
−
|1972-1974
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#CVP|CVP]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of ORR
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]] 75 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Bleomycin (Blenoxane)]] 15 mg/m<sup>2</sup> IV once per day on days 1 & 8
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg/m<sup>2</sup> IM once per day on days 1 to 5
 
−
'''21-day cycle for at least 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# Monfardini S, Tancini G, De Lena 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://doi.org/10.1002/mpo.2950030110 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/65728 PubMed]
 
−
==ACE {{#subobject:e05345|Regimen=1}}==
 
−
ACE: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:5ac5a4|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1038/sj.leu.2401955 Dumontet et al. 2000]
 
−
|1995-1998
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdp237 Haioun et al. 2009 (LNH 98-3)]
 
−
|1999-2004
 
−
|style="background-color:#1a9851"|Phase 3 (E-de-esc)
 
−
|[[#ACVBP|ACVBP]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]] 75 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 2
 
−
*[[Etoposide (Vepesid)]] as follows:
 
−
**Cycles 2 to 4: 150 mg/m<sup>2</sup> IV once per day on days 1 to 3
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> (route not specified) once per day on days 1 to 5
 
−
====CNS therapy, prophylaxis====
 
−
*[[Methotrexate (MTX)]] 15 mg IT once on day 2
 
−
====Supportive therapy====
 
−
*[[:Category:Granulocyte colony-stimulating factors|G-CSF]] 5 mcg/kg/day SC on days 6 to 13
 
−
</div></div>
 
−
===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://doi.org/10.1038/sj.leu.2401955 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11187906 PubMed]
 
−
# '''LNH 98-3:''' 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. [https://doi.org/10.1093/annonc/mdp237 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/19567453 PubMed]
 
−
==ACOMLA {{#subobject:6cce0e|Regimen=1}}==
 
−
ACOMLA: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>M</u>'''ethotrexate, '''<u>L</u>'''eucovorin (Folinic acid), '''<u>A</u>'''ra-C (Cytarabine)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:e9a344|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/6177407 Newcomer et al. 1982]
 
−
|NR in abstract
 
−
|style="background-color:#91cf61"|Randomized, <20 patients
 
−
|[[#CHOP-B|CHOP-B]]
 
−
| style="background-color:#fc8d59" |Seems to have inferior RFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Methotrexate (MTX)]]
 
−
*[[Cytarabine (Ara-C)]]
 
−
</div></div>
 
−
===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://pubmed.ncbi.nlm.nih.gov/6177407 PubMed]
 
−
==ACVBP {{#subobject:bb17b2|Regimen=1}}==
 
−
ACVBP: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''indesine, '''<u>B</u>'''leomycin, '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Protocol {{#subobject:1cd335|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.2000.18.6.1309 Tilly et al. 2000 (LNH87-1)]
 
−
|1987-1993
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#m-BACOD|m-BACOD]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of FFS
 
−
|-
 
−
|[http://www.bloodjournal.org/content/102/13/4284.long Tilly et al. 2003]
 
−
|1993-1998
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP]]
 
−
|style="background-color:#91cf60"|Seems to have superior OS
 
−
|-
 
−
|[https://doi.org/10.3109/10428194.2010.504871 Morel et al. 2010 (LNH93-2)]
 
−
|1993-1998
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[Stub#ECVBP|ECVBP]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJMoa042040 Reyes et al. 2005 (LNH 93-01)]
 
−
|1993-2000
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP]], then [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|RT]]
 
−
|style="background-color:#1a9850"|Superior OS<br>OS60: 90% vs 81%
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdp237 Haioun et al. 2009 (LNH 98-3)]
 
−
|1999-2004
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ACE|ACE]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mds600 Ketterer et al. 2013 (LNH03-1B)]
 
−
|2003-2008
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[Diffuse_large_B-cell_lymphoma#R-ACVBP|R-ACVBP]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior PFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy, induction====
 
−
*[[Doxorubicin (Adriamycin)]] 75 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cyclophosphamide (Cytoxan)]] 1200 mg/m<sup>2</sup> IV once on day 1
 
−
*[[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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
====CNS therapy, prophylaxis====
 
−
*[[Methotrexate (MTX)]] 15 mg IT on day 2
 
−
====Supportive therapy====
 
−
*[[:Category:Granulocyte_colony-stimulating_factors|G-CSF or GM-CSF]] SC once per day on days 6 to 13
 
−
'''21-day cycle for 4 cycles, followed by:'''
 
−
====Chemotherapy, consolidation, part 1====
 
−
*[[Methotrexate (MTX)]] 3000 mg/m<sup>2</sup> IV once on day 1
 
−
====Supportive therapy====
 
−
*[[Folinic acid (Leucovorin)|Leucovorin]] rescue
 
−
'''14-day cycle for 2 cycles, followed by:'''
 
−
====Chemotherapy, consolidation, part 2====
 
−
*[[Etoposide (Vepesid)]] 300 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Ifosfamide (Ifex)]] 1500 mg/m<sup>2</sup> IV once on day 1
 
−
====Supportive therapy====
 
−
*[[Mesna (Mesnex)]] "protection" (details not provided)
 
−
'''14-day cycle for 4 cycles''', beginning 2 weeks after completion of MTX, then
 
−
====Chemotherapy, consolidation, part 3====
 
−
*[[Cytarabine (Ara-C)]] 100 mg/m<sup>2</sup> SC once per day on days 1 to 4
 
−
'''14-day cycle for 2 cycles''', beginning 2 weeks after completion of EI
 
−
</div></div>
 
−
===References===
 
−
# '''LNH87-1:''' Tilly H, Mounier N, Lederlin P, Brière J, Dupriez B, Sebban C, Bosly A, Biron P, Nouvel C, Herbrecht R, Bordessoule D, Coiffier B; Groupe d'Etude des Lymphomes de l'Adulte. Randomized comparison of ACVBP and m-BACOD in the treatment of patients with low-risk aggressive lymphoma: the LNH87-1 study. J Clin Oncol. 2000 Mar;18(6):1309-15. [https://doi.org/10.1200/jco.2000.18.6.1309 link to original article] [https://pubmed.ncbi.nlm.nih.gov/10715302 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12920037 PubMed]
 
−
# '''LNH 93-01:''' 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. ACVBP versus CHOP plus radiotherapy for localized aggressive lymphoma. N Engl J Med. 2005 Mar 24;352(12):1197-205. [https://doi.org/10.1056/NEJMoa042040 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15788496 PubMed]
 
−
# '''LNH 98-3:''' 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. [https://doi.org/10.1093/annonc/mdp237 link to original article] [https://pubmed.ncbi.nlm.nih.gov/19567453 PubMed]
 
−
# '''LNH93-2:''' Morel P, Munck JN, Coiffier B, Gisselbrecht C, Ranta D, Bosly A, Tilly H, Quesnel B, Thyss A, Mounier N, Brière J, Molina T, Reyes F; GELA. Comparison of two high-dose cyclophosphamide, doxorubicin, vincristine, and prednisone derived regimens in patients aged under 60 years with low-intermediate risk aggressive lymphoma: a final analysis of the multicenter LNH93-2 protocol. Leuk Lymphoma. 2010 Sep;51(9):1668-77. [https://doi.org/10.3109/10428194.2010.504871 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20807094 PubMed]
 
−
# '''LNH03-1B:''' 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; GELA. 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. [https://doi.org/10.1093/annonc/mds600 link to original article] [https://pubmed.ncbi.nlm.nih.gov/23235801 PubMed] NCT00140595
 
−
==ACVBP (Methylprednisolone) {{#subobject:015a69|Regimen=1}}==
 
−
ACVBP: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''indesine, '''<u>B</u>'''leomycin, Methyl'''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:2tq46d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1986.4.2.147 Coiffier et al. 1986 (LNH-80)]
 
−
|1980-1984
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
''Note: this regimen is referred to as "intensified CHOP-Bleo" in the original manuscript, but bears more resemblance to ACVBP induction and is therefore re-named as ACVBP.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]] 75 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cyclophosphamide (Cytoxan)]] 1200 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vindesine (Eldisine)]] 2 mg/m<sup>2</sup> IV once per day on days 1 & 5
 
−
*[[Bleomycin (Blenoxane)]] 5 mg/m<sup>2</sup> IV once per day on days 1 to 5
 
−
====Glucocorticoid therapy====
 
−
*[[Methylprednisolone (Solumedrol)]] 60 mg/m<sup>2</sup> (route not specified) once per day on days 1 to 5
 
−
====CNS therapy, prophylaxis====
 
−
*[[Methotrexate (MTX)]] 15 mg IT once
 
−
'''15-day cycle for 3 cycles; cycles were delayed until ANC greater than 1500/uL'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*[[#Cytarabine_.26_Methotrexate_.28CYM.29_88|CYM]], then [[#CVAP-Bleo|CVAP-Bleo]]
 
−
</div></div>
 
−
===References===
 
−
# '''LNH-80:''' Coiffier B, Bryon PA, Berger F, Archimbaud E, Ffrench M, Extra JM, Guyotat D, Fiere D, Gentilhomme O, Magaud JP, Blanc M, Peaud PY, Vuvan H, Viala JJ. Intensive and sequential combination chemotherapy for aggressive malignant lymphomas (protocol LNH-80). J Clin Oncol. 1986 Feb;4(2):147-53. [https://doi.org/10.1200/jco.1986.4.2.147 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/2418166 PubMed]
 
−
==BCOP {{#subobject:f79d88|Regimen=1}}==
 
−
BCOP: '''<u>B</u>'''CNU (Carmustine), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine),  '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:39f753|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.1985.3.9.1188 Gams et al. 1985]
 
−
|1977-1981
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#CHOP|CHOP]]
 
−
|style="background-color:#fee08b"|Might have inferior OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Carmustine (BCNU)]] 100 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 1 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''28-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# Gams RA, Rainey M, Dandy M, Bartolucci AA, Silberman H, Omura G; Southeastern Cancer Study Group. Phase III study of BCOP v CHOP in unfavorable categories of malignant lymphoma: a Southeastern Cancer Study Group trial. J Clin Oncol. 1985 Sep;3(9):1188-95. [https://doi.org/10.1200/JCO.1985.3.9.1188 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/3897470 PubMed]
 
−
==CAP-BOP {{#subobject:dc0598|Regimen=1}}==
 
−
CAP-BOP: '''<u>C</u>'''yclophosphamide, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>P</u>'''rocarbazine, '''<u>B</u>'''leomycin, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<br>COP-BLAM: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>BL</u>'''eomycin, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>M</u>'''atulane (Procarbazine), 
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:be42ea|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.7326/0003-4819-97-2-190 Laurence et al. 1982]
 
−
|1977-1981
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1988.6.3.425 Boyd et al. 1988]
 
−
|1981-1984
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1986.4.2.160 Armitage et al. 1986]
 
−
|1982-1984
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1988.6.12.1838 Vose et al. 1988]
 
−
|1982-1986
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Procarbazine (Matulane)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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. [https://doi.org/10.7326/0003-4819-97-2-190 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6179448 PubMed]
 
−
# Armitage JO, Weisenburger DD, Hutchins M, Moravec DF, Dowling M, Sorensen S, Mailliard J, Okerbloom J, Johnson PS, Howe D, Bascom GK, Casey J, Linder J, Purtilo DT. Chemotherapy for diffuse large-cell lymphoma--rapidly responding patients have more durable remissions. J Clin Oncol. 1986 Feb;4(2):160-4. [https://doi.org/10.1200/jco.1986.4.2.160 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2418167 PubMed]
 
−
# Boyd DB, Coleman M, Papish SW, Topilow A, Kopel SK, Bernhardt B, Files JC, Schwartz S, Gaynor M, McDermott D, Reisman AM, Coleman BL. COPBLAM III: infusional combination chemotherapy for diffuse large-cell lymphoma. J Clin Oncol. 1988 Mar;6(3):425-33. [https://doi.org/10.1200/jco.1988.6.3.425 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2450970 PubMed]
 
−
# Vose JM, Armitage JO, Weisenburger DD, Bierman PJ, Sorensen S, Hutchins M, Moravec DF, Howe D, Dowling MD, Mailliard J, Johnson PS, Pevnick W, Packard WM, Okerbloom J, Thompson RF, Langdon RM Jr, Soori G, Peterson C. 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. [https://doi.org/10.1200/jco.1988.6.12.1838 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2462026 PubMed]
 
−
==CCOP {{#subobject:9a2b69|Regimen=1}}==
 
−
CCOP: '''<u>C</u>'''yclophosphamide, '''<u>C</u>'''aelyx (Pegylated liposomal doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:4efe2a|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[http://www.haematologica.org/content/87/8/822.long Martino et al. 2002]
 
−
|1998-2000
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV over 30 minutes once on day 1
 
−
*[[Pegylated liposomal doxorubicin (Doxil)]] 30 mg/m<sup>2</sup> IV over 60 minutes once on day 1
 
−
*[[Vincristine (Oncovin)]] 2 mg IV over 15 minutes once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''21-day cycle for 6 to 8 cycles'''
 
−
</div></div>
 
−
===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. [http://www.haematologica.org/content/87/8/822.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12161358 PubMed]
 
−
==CEEP {{#subobject:31f2c7|Regimen=1}}==
 
−
CEEP: '''<u>C</u>'''yclophosphamide,  '''<u>E</u>'''pirubicin, '''<u>E</u>'''ldesine (Vindesine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:1bbbf3|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJMoa031770 Milpied et al. 2004 (GOELAMS 072)]
 
−
|1994-1999
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP]]
 
−
| style="background-color:#91cf60" |Seems to have superior EFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 1200 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Epirubicin (Ellence)]] 100 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vindesine (Eldisine)]] 3 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 80 mg/m<sup>2</sup> PO or IV once per day on days 1 to 5
 
−
====CNS therapy, prophylaxis====
 
−
*[[Methotrexate (MTX)]] 15 mg IT once on day 2
 
−
*[[Methylprednisolone (Solumedrol)]] IT once on day 2
 
−
'''2 cycles'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*Patients with at least PR: [[#Cytarabine_.26_Methotrexate_.28CYM.29_88|CYM]], then [[#BEAM.2C_then_auto_HSCT_88|BEAM with auto HSCT]]
 
−
</div></div>
 
−
===References===
 
−
# '''GOELAMS 072:''' Milpied N, Deconinck E, Gaillard F, Delwail V, Foussard C, Berthou C, Gressin R, Lucas V, Colombat P, Harousseau JL; Groupe Ouest-Est des Leucémies et des Autres Maladies du Sang. Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med. 2004 Mar 25;350(13):1287-95. [https://doi.org/10.1056/NEJMoa031770 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15044639 PubMed]
 
−
==CEOP {{#subobject:76ytfe|Regimen=1}}==
 
−
CEOP: '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''pirubicin, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a8h895|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1034/j.1600-0609.2002.01620.x Economopoulos et al. 2002]
 
−
|1993-1999
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#CNOP|CNOP]]
 
−
| style="background-color:#ffffbf" |Did not meet efficacy endpoints
 
−
|-
 
−
|[https://www.karger.com/Article/Abstract/87284 Chamorey et al. 2005]
 
−
|1994-1998
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#MEMID_99|MEMID]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1097/PPO.0b013e3181570170 Economopoulos et al. 2007 (HE22A99)]
 
−
|1999-2005
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#CEOP-14_99|CEOP-14]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Epirubicin (Ellence)]] 70 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 2 mg IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg PO once per day on days 1 to 7
 
−
'''21-day cycles'''
 
−
</div></div>
 
−
===References===
 
−
# Economopoulos T, Dimopoulos MA, Mellou S, Pavlidis N, Samantas E, Nicolaides C, Tsatalas C, Papadopoulos A, Papageogriou E, Papasavvas P, Fountzilas G. Treatment of intermediate- and high-grade non-Hodgkin's lymphoma using CEOP versus CNOP. Eur J Haematol. 2002 Mar;68(3):135-43. [https://doi.org/10.1034/j.1600-0609.2002.01620.x link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12068793 PubMed]
 
−
# Chamorey E, Gressin R, Peyrade F, Rossi JF, Lepeu G, Foussard C, Harrousseau JL, Fabbro M, Richard B, Delwail V, Maisonneuve H, Vilque JP, Thyss A. Prospective randomized study comparing MEMID with a chop-like regimen in elderly patients with aggressive non-Hodgkin's lymphoma. Oncology. 2005;69(1):19-26. Epub 2005 Jul 28. [https://www.karger.com/Article/Abstract/87284 link to original article] [https://pubmed.ncbi.nlm.nih.gov/16088231 PubMed]
 
−
# '''HE22A99:''' Economopoulos T, Psyrri A, Dimopoulos MA, Kalogera-Fountzila A, Pavlidis N, Tsatalas C, Nikolaides C, Mellou S, Xiros N, Fountzilas G; Hellenic Cooperative Oncology Group. CEOP-21 versus CEOP-14 chemotherapy with or without rituximab for the first-line treatment of patients with aggressive lymphomas: results of the HE22A99 trial of the Hellenic Cooperative Oncology Group. Cancer J. 2007 Sep-Oct;13(5):327-34. [https://doi.org/10.1097/PPO.0b013e3181570170 link to original article] [https://pubmed.ncbi.nlm.nih.gov/17921732 PubMed]
 
−
==CEOP (Prednisolone) {{#subobject:1560fe|Regimen=1}}==
 
−
CEOP: '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''pirubicin, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisolone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:550895|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1002/ajh.23684 Hertzberg et al. 2014 (ALLG NHL07)]
 
−
|1994-1999
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#Dose-intense_CEOP_99|DI-CEOP]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of OS60
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Epirubicin (Ellence)]] 75 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# '''ALLG NHL07:''' Hertzberg M, Matthews JP, Stone JM, Dubosq MC, Grigg A, Ellis D, Benson W, Browett P, Horvath N, Januszewicz H, Abdi E, Green M, Bonaventura A, Marlton P, Cannell P, Wolf M; ALLG. A phase III randomized trial of high-dose CEOP + filgrastim versus standard-dose CEOP in patients with non-Hodgkin lymphoma: 10-year follow-up data: Australasian Leukaemia and Lymphoma Group (ALLG) NHL07 trial. Am J Hematol. 2014 May;89(5):536-41. Epub 2014 Feb 21. [https://doi.org/10.1002/ajh.23684 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/24481640 PubMed]
 
−
==CHOEP-14 {{#subobject:c516ab|Regimen=1}}==
 
−
CHOEP-14: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>E</u>'''toposide, '''<u>P</u>'''rednisone every '''<u>14</u>''' days
 
−
<br>CHOPE: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne, '''<u>E</u>'''toposide
 
−
<br>VACOP: '''<u>V</u>'''epesid (Etoposide), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:f61648|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 17%"|Study
 
−
!style="width: 15%"|Years of enrollment
 
−
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 17%"|Comparator
 
−
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
 
−
|-
 
−
|rowspan=2|[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
 
−
|rowspan=2|1993-2000
 
−
|rowspan=2 style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP|CHOP-21]]<br>2. [[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#1a9850" |Superior EFS
 
−
|style="background-color:#fc8d59"|Seems more toxic
 
−
|-
 
−
|3. [[#CHOEP-21|CHOEP-21]]
 
−
| style="background-color:#91cf60" |Seems to have superior OS
 
−
|
 
−
|-
 
−
|[http://www.bloodjournal.org/content/104/3/634.long Pfreundschuh et al. 2004 (NHL-B2)]
 
−
|1993-2000
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOEP-21|CHOEP-21]]<br>2. [[#CHOP|CHOP-21]]<br> 3. [[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS
 
−
|style="background-color:#fc8d59"|Seems more toxic
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 1 to 3
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] by the following weight-based criteria:
 
−
**Patients less than 75 kg: 300 mcg SC once per day on days 4 to 13
 
−
**Patients at least 75 kg: 480 mcg SC once per day on days 4 to 13
 
−
'''14-day cycle for 6 cycles''', next cycle to start as long as WBC count is greater than 2.5 x 10<sup>9</sup>/L and platelets greater than 80 x 10<sup>9</sup>/L
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*Some protocols: Patients with initial bulky disease (mass conglomerate at least 7.5 cm) received 36 Gy [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|radiation therapy]] to extranodal sites of disease when possible
 
−
</div></div>
 
−
===References===
 
−
# '''NHL-B1:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/14982884 PubMed]
 
−
# '''NHL-B2:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1016/S1470-2045%2806%2970664-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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 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 Group. Lancet Oncol. 2011 Oct;12(11):1013-22. [https://doi.org/10.1016/S1470-2045%2811%2970235-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21940214 PubMed]
 
−
==CHOEP-21 {{#subobject:cad12b|Regimen=1}}==
 
−
CHOEP-21: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>E</u>'''toposide, '''<u>P</u>'''rednisone every '''<u>21</u>''' days
 
−
<br>CHOPE: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne, '''<u>E</u>'''toposide
 
−
<br>VACOP: '''<u>V</u>'''epesid (Etoposide), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:18ddca|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 17%"|Study
 
−
!style="width: 15%"|Years of enrollment
 
−
!style="width: 17%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 17%"|Comparator
 
−
!style="width: 17%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
!style="width: 17%"|[[Levels_of_Evidence#Toxicity|Comparative Toxicity]]
 
−
|-
 
−
|[https://doi.org/10.1002/hon.2900090407 Köppler et al. 1991]
 
−
|NR
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#hCHOP.2FIVEP|hCHOP/IVEP]]
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.2002.07.075 Kaiser et al. 2002]
 
−
|1990-1997
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHOEP-21|CHOEP]], then [[#BEAM.2C_then_auto_HSCT|BEAM with auto HSCT]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of OS
 
−
|
 
−
|-
 
−
|rowspan=2|[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
 
−
|rowspan=2|1993-2000
 
−
|rowspan=2 style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP|CHOP-21]]<br>2. [[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#1a9850" |Superior EFS
 
−
|style="background-color:#fc8d59"|Seems more toxic
 
−
|-
 
−
|3. [[#CHOEP-14|CHOEP-14]]
 
−
| style="background-color:#fc8d59" |Seems to have inferior OS
 
−
|
 
−
|-
 
−
|[http://www.bloodjournal.org/content/104/3/634.long Pfreundschuh et al. 2004 (NHL-B2)]
 
−
|1993-2000
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOEP-14|CHOEP-14]]<br>2. [[#CHOP|CHOP-21]]<br> 3. [[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS
 
−
|style="background-color:#fc8d59"|Seems more toxic
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdm514 Pfreundschuh et al. 2007 (DSHNHL-1999-2)]
 
−
|2000-2003
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#MegaCHOEP_99|High CHOEP-21]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS36
 
−
| style="background-color:#1a9850" |Less toxic
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV once per day on days 1 to 3
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] by discretion of ordering physician
 
−
'''21-day cycle for 4 to 6 cycles''', next cycle to start as long as WBC is >2.5 and platelets >80
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*Some protocols: Patients with initial bulky disease (mass conglomerate at least 7.5 cm) received 36 Gy [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|radiation therapy]] to extranodal sites of disease when possible
 
−
</div></div>
 
−
===References===
 
−
# Köppler H, Pflüger KH, Eschenbach I, Pfab R, Birkmann J, Zeller W, Steinhauer EU, Gropp C, Oehl S, Lötzke E, Kuhn H, Drings P, Gossmann HH, Lennert K, Stein H, Havemann K. 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. [https://doi.org/10.1002/hon.2900090407 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1743624 PubMed]
 
−
# Kaiser U, Uebelacker I, Abel U, Birkmann J, Trümper L, Schmalenberg H, Karakas T, Metzner B, Hossfeld DK, Bischoff HG, Franke A, Reiser M, Müller P, Mantovani L, Grundeis M, Rothmann F, von Seydewitz CU, Mesters RM, Steinhauer EU, Krahl D, Schumacher K, Kneba M, Baudis M, Schmitz N, Pfab R, Köppler H, Parwaresch R, Pfreundschuh M, Havemann K. Randomized study to evaluate the use of high-dose therapy as part of primary treatment for "aggressive" lymphoma. J Clin Oncol. 2002 Nov 15;20(22):4413-9. [https://doi.org/10.1200/JCO.2002.07.075 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12431962 PubMed]
 
−
# '''NHL-B1:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/14982884 PubMed]
 
−
# '''NHL-B2:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1016/S1470-2045%2806%2970664-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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 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. [https://doi.org/10.1016/S1470-2045%2811%2970235-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21940214 PubMed]
 
−
# '''DSHNHL-1999-2:''' Pfreundschuh M, Zwick C, Zeynalova S, Dührsen U, Pflüger KH, Vrieling T, Mesters R, Mergenthaler HG, Einsele H, Bentz M, Lengfelder E, Trümper L, Rübe C, Schmitz N, Loeffler M; German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Dose-escalated CHOEP for the treatment of young patients with aggressive non-Hodgkin's lymphoma: II - Results of the randomized high-CHOEP trial of the German High-Grade Non-Hodgkin's Lymphoma Study Group (DSHNHL). Ann Oncol. 2008 Mar;19(3):545-52. Epub 2007 Dec 6. [https://doi.org/10.1093/annonc/mdm514 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18065407/ PubMed] NCT00053768
 
−
==CHOP {{#subobject:4ca454|Regimen=1}}==
 
−
CHOP: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #1, 3 cycles, prednisone 40 mg/m<sup>2</sup> {{#subobject:4893da|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199004263221701 Link et al. 1990]
 
−
|1983-1987
 
−
|style="background-color:#1a9851"|Phase 3 (E-de-esc)
 
−
|[[#CHOP_.26_RT_88|CHOP & RT]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of DFS
 
−
|-
 
−
|}
 
−
''Note: this is a component of a sequential treatment protocol; to our knowledge there are no references to support using it as a stand-alone treatment. Note some substantial differences from typical CHOP protocols.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] as follows:
 
−
**Cycle 1: 40 mg/m<sup>2</sup> PO once per day on days 1 to 21
 
−
**Cycle 2: 40 mg/m<sup>2</sup> PO once per day on days 1 to 7
 
−
**Cycle 3: 40 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''21-day cycle for 3 cycles'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*6-MP & MTX maintenance
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #2, 3 cycles, prednisone 100 mg {{#subobject:503b17|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199807023390104 Miller et al. 1998 (SWOG S8736)]
 
−
|1988-1995
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ooc)
 
−
|[[Complex_multipart_regimens#SWOG_S8736|See link]]
 
−
| style="background-color:#91cf60" |[[Complex_multipart_regimens#SWOG_S8736|See link]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJMoa042040 Reyes et al. 2005 (LNH 93-01)]
 
−
|1993-2000
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ACVBP|ACVBP]]
 
−
|style="background-color:#d73027"|Inferior OS
 
−
|-
 
−
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287635/ Persky et al. 2014 (SWOG S0313)]
 
−
|2004-2008
 
−
|style="background-color:#91cf61"|Phase 2
 
−
| style="background-color:#d3d3d3" |
 
−
| style="background-color:#d3d3d3" |
 
−
|-
 
−
|}
 
−
''Note: this is a component of a sequential treatment protocol; to our knowledge there are no references to support using it as a stand-alone treatment.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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 over 1 to 2 minutes once on day 1
 
−
*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV over 1 to 2 minutes once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 3 cycles'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*SWOG S0313: [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|IFRT]], then [[#Ibritumomab_tiuxetan_protocol|ibritumomab tiuxetan]] consolidation
 
−
*Others (see papers): [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|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.
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #3, 4 cycles {{#subobject:5368c8|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1993.11.4.720 Tondini et al. 1993]
 
−
|1985-1990
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.2006.07.0722 Bonnet et al. 2007]
 
−
|1993-2002
 
−
|style="background-color:#91cf61"|Non-randomized portion of RCT
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''21-day cycle for 4 cycles'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*[[Diffuse_large_B-cell_lymphoma#Radiation_therapy|IFRT]] x 40 Gy versus [[Diffuse_large_B-cell_lymphoma#Observation|no further treatment]]
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #4, 6 cycles, 100 mg prednisone {{#subobject:9e770b|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|rowspan=2|[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
 
−
|rowspan=2|1993-2000
 
−
|rowspan=2 style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[#CHOEP-14|CHOEP-14]]<br>2. [[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior OS
 
−
|-
 
−
|3. [[#CHOEP-21|CHOEP-21]]
 
−
|style="background-color:#d73027"|Inferior EFS
 
−
|-
 
−
|rowspan=3|[http://www.bloodjournal.org/content/104/3/634.long Pfreundschuh et al. 2004 (NHL-B2)]
 
−
|rowspan=3|1993-2000
 
−
|rowspan=3 style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[#CHOEP-14|CHOEP-14]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS
 
−
|-
 
−
|2. [[#CHOEP-21|CHOEP-21]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS
 
−
|-
 
−
|3. [[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#d73027"|Inferior OS
 
−
|-
 
−
|[http://www.bloodjournal.org/content/109/7/2759.long Verdonck et al. 2007 (HOVON-26)]
 
−
|1994-2004
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHOP-14|I-CHOP]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1007/s00277-009-0811-x Fridrik et al. 2009 (AGMT NHL-5)]
 
−
|1995-2001
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CEOP.2FIMVP-Dexa_88|CEOP/IMVP-Dexa]]
 
−
| style="background-color:#d73027" |Inferior OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#cbd5e8">
 
−
====Preceding treatment====
 
−
*NHL-B1 and NHL-B2: [[Diffuse_large_B-cell_lymphoma#Vincristine_.26_Prednisone|Pre-phase vincristine & prednisone]]
 
−
</div>
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*Per '''NHL-B1''' and '''NHL-B2''': At the discretion of ordering physician: [[Filgrastim (Neupogen)]] 300 mcg (for patients less than 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'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*NHL-B2, patients with "lymphoma masses or conglomerates with a diameter ≥7.5 cm) or extranodal involvement": [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|RT]] x 36 Gy to areas of initial bulky disease
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #5, 6 cycles, 50 mg/m<sup>2</sup> prednisone {{#subobject:9f1357|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.1995.13.10.2530 Sonneveld et al. 1995]
 
−
|1988-1993
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CNOP|CNOP]]
 
−
| style="background-color:#91cf60" |Seems to have superior OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 50 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''28-day cycle for 6 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #6, 6 to 8 cycles {{#subobject:5b37b5|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.3109/10428199509107906 Zinzani et al. 1995]
 
−
|1991-1993
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CIOP_99|CIOP]]
 
−
| style="background-color:#ffffbf" |Did not meet efficacy endpoints
 
−
|-
 
−
|[https://doi.org/10.1200/jco.2005.05.1003 Habermann et al. 2006 (ECOG E4494)]
 
−
|1998-2001
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior FFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] "recommended according to guidelines"
 
−
'''21-day cycle for 6 to 8 cycles'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*ECOG E4494, patients with CR/PR: [[Diffuse_large_B-cell_lymphoma#Rituximab_monotherapy|Rituximab]] maintenance versus [[Diffuse_large_B-cell_lymphoma_-_null_regimens#Observation|observation]]
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #7, 8 cycles, 40 mg/m<sup>2</sup> prednisone {{#subobject:9f1357|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/102/13/4284.long Tilly et al. 2003]
 
−
|1993-1998
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ACVBP|ACVBP]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior OS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJMoa011795 Coiffier et al. 2002 (LNH 98-5)]
 
−
|1998-2000
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]]
 
−
|style="background-color:#d73027"|Inferior OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] used for later cycles if patients developed grade 4 neutropenia or febrile neutropenia
 
−
'''21-day cycle for 8 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #8, 8 cycles, 100 mg prednisone {{#subobject:256065|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1002/1097-0142(197610)38:4%3C1484::aid-cncr2820380407%3E3.0.co;2-i McKelvey et al. 1976]
 
−
|1972-1974
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#HOP|HOP]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1002/1097-0142(197810)42:4%3C1705::AID-CNCR2820420408%3E3.0.CO;2-P Elias et al. 1978]
 
−
|1974-1977
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|rowspan=3|[https://doi.org/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 
−
|rowspan=3|1986-1991
 
−
|rowspan=3 style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[#MACOP-B|MACOP-B]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of OS
 
−
|-
 
−
|2. [[#m-BACOD|m-BACOD]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of OS
 
−
|-
 
−
|3. [[#ProMACE-CytaBOM|ProMACE-CytaBOM]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199504203321601 Verdonck et al. 1995]
 
−
|1987-1994
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHOP|CHOP]] x 3, then HDT with auto HSCT
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of EFS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199807023390104 Miller et al. 1998 (SWOG S8736)]
 
−
|1988-1995
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHOP|CHOP]] x 3, then [[Diffuse_large_B-cell_lymphoma#Radiation_therapy|RT]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior OS
 
−
|-
 
−
|[https://doi.org/10.1023/a:1008392528248 Jerkeman et al. 1999]
 
−
|1989-1994
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#MACOP-B|MACOP-B]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdl153 Betticher et al. 2006 (MISTRAL)]
 
−
|1997-2003
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#SHiDo_99|SHiDo]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdq619 Ohmachi et al. 2010 (JCOG 9809)]
 
−
|1999-2002
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHOP-14|CHOP-14]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of PFS
 
−
|-
 
−
|}
 
−
''Note: McKelvey et al. 1976 gave CHOP for 3 cycles past CR.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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 over 1 to 2 minutes once on day 1
 
−
*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV over 1 to 2 minutes once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 8 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #9, 8 cycles, uncapped vincristine, 100 mg prednisone {{#subobject:d4f664|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.1985.3.9.1188 Gams et al. 1985]
 
−
|1977-1981
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#BCOP|BCOP]]
 
−
|style="background-color:#d9ef8b"|Might have superior OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 600 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 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 8 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #10, 8 cycles, uncapped vincristine, 100 mg/m<sup>2</sup> prednisone {{#subobject:872c7f|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJMoa031770 Milpied et al. 2004 (GOELAMS 072)]
 
−
|1994-1999
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CEEP|CEEP]], then [[#Cytarabine_.26_Methotrexate_.28CYM.29_88|CYM]], then [[#BEAM.2C_then_auto_HSCT_88|BEAM with auto HSCT]]
 
−
| style="background-color:#fc8d59" |Seems to have inferior EFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''21-day cycle for 8 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #11, other {{#subobject:889c7f|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.3109/02841869009091789 Andersen et al. 1990]
 
−
|1983-1985
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CisEBP_99|CisEBP]]
 
−
| style="background-color:#1a9850" |Superior CR rate
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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://doi.org/10.1002/1097-0142(197610)38:4%3C1484::aid-cncr2820380407%3E3.0.co;2-i link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1002/1097-0142(197810)42:4%3C1705::AID-CNCR2820420408%3E3.0.CO;2-P link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/361209 PubMed]
 
−
# Gams RA, Rainey M, Dandy M, Bartolucci AA, Silberman H, Omura G; Southeastern Cancer Study Group. Phase III study of BCOP v CHOP in unfavorable categories of malignant lymphoma: a Southeastern Cancer Study Group trial. J Clin Oncol. 1985 Sep;3(9):1188-95. [https://doi.org/10.1200/JCO.1985.3.9.1188 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3897470 PubMed]
 
−
# Link MP, Donaldson SS, Berard CW, Shuster JJ, Murphy SB; POG. Results of treatment of childhood localized non-Hodgkin's lymphoma with combination chemotherapy with or without radiotherapy. N Engl J Med. 1990 Apr 26;322(17):1169-74. [https://doi.org/10.1056/NEJM199004263221701 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/2183052 PubMed]
 
−
# Andersen J, Thorling K, Bentzen SM, Brincker H, Christensen BE, Pedersen M; Danish Lymphoma Study Group. Phase III trial of cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) versus cisplatin, etoposide, bleomycin and prednisone (CisEBP) for the treatment of advanced non-Hodgkin's lymphoma of high grade malignancy. Acta Oncol. 1990;29(8):995-9. [https://doi.org/10.3109/02841869009091789 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1703769 PubMed]
 
−
# Pavlovsky S, Santarelli MT, Erazo A, Diaz Maqueo JC, Somoza N, Lluesma Goñalons M, Cervantes G, Garcia Vela EL, Corrado C, Magnasco H, Milone G. 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. [https://doi.org/10.1093/oxfordjournals.annonc.a058153 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1586618 PubMed]
 
−
# '''SWOG-8516/Intergroup 0067:''' 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. [https://doi.org/10.1056/NEJM199304083281404 link to original article] [https://pubmed.ncbi.nlm.nih.gov/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://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1200/jco.2008.16.8021 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4879698/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1200/jco.1993.11.4.720 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8478665 PubMed]
 
−
# Verdonck LF, van Putten WL, Hagenbeek A, Schouten HC, Sonneveld P, van Imhoff GW, Kluin-Nelemans HC, Raemaekers JM, van Oers RH, Haak HL, Schots R, Dekker AW, de Gast GC, Löwenberg B. Comparison of CHOP chemotherapy with autologous bone marrow transplantation for slowly responding patients with aggressive non-Hodgkin's lymphoma. N Engl J Med. 1995 Apr 20;332(16):1045-51. [https://doi.org/10.1056/NEJM199504203321601 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7898521 PubMed]
 
−
# Zinzani PL, Martelli M, Storti S, Musso M, Cantonetti M, Leone G, Cajozzo A, Papa G, Iannitto E, Perrotti A, Bendandi M, Gherlinzoni F, Gentilini P, Rossi G, Aitini E, Mandelli F, Tura S. Phase III comparative trial using CHOP vs CIOP in the treatment of advanced intermediate-grade non-Hodgkin's lymphoma. Leuk Lymphoma. 1995 Oct;19(3-4):329-35. [https://doi.org/10.3109/10428199509107906 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8535227 PubMed]
 
−
# Sonneveld P, de Ridder M, van der Lelie H, Nieuwenhuis K, Schouten H, Mulder A, van Reijswoud I, Hop W, Lowenberg B. Comparison of doxorubicin and mitoxantrone in the treatment of elderly patients with advanced diffuse non-Hodgkin's lymphoma using CHOP versus CNOP chemotherapy. J Clin Oncol. 1995 Oct;13(10):2530-9. [https://doi.org/10.1200/JCO.1995.13.10.2530 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7595704 PubMed]
 
−
# '''SWOG S8736:''' 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. [https://doi.org/10.1056/NEJM199807023390104 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/9647875 PubMed] NCT00005089
 
−
##'''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. [https://doi.org/10.1200/jco.2015.65.4582 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5012710/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/27382104 PubMed]
 
−
# Jerkeman M, Anderson H, Cavallin-Ståhl E, Dictor M, Hagberg H, Johnson A, Kaasa S, Kvaløy S, Sundström C, Akerman M; Nordic Lymphoma Group. CHOP versus MACOP-B in aggressive lymphoma--a Nordic Lymphoma Group randomised trial. Ann Oncol. 1999 Sep;10(9):1079-86. [https://doi.org/10.1023/a:1008392528248 link to original article] '''does not contain dosing details''' [https://pubmed.ncbi.nlm.nih.gov/10572606 PubMed]
 
−
# '''LNH 98-5:''' 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; Groupe d'Etude des Lymphomes de l'Adulte. 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. [https://doi.org/10.1056/NEJMoa011795 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1200/jco.2005.09.131 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/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 dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2951853/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/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. 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. [https://doi.org/10.1016/j.clml.2011.11.004 link to original article] [https://pubmed.ncbi.nlm.nih.gov/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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12920037 PubMed]
 
−
# '''NHL-B1:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/14982884 PubMed]
 
−
# '''NHL-B2:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15016643 PubMed]
 
−
# '''GOELAMS 072:''' Milpied N, Deconinck E, Gaillard F, Delwail V, Foussard C, Berthou C, Gressin R, Lucas V, Colombat P, Harousseau JL; Groupe Ouest-Est des Leucémies et des Autres Maladies du Sang. Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med. 2004 Mar 25;350(13):1287-95. [https://doi.org/10.1056/NEJMoa031770 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/15044639 PubMed]
 
−
# '''ECOG E1484:''' 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. [https://doi.org/10.1200/jco.2004.06.088 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15210738 PubMed]
 
−
# '''LNH 93-01:''' 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. ACVBP versus CHOP plus radiotherapy for localized aggressive lymphoma. N Engl J Med. 2005 Mar 24;352(12):1197-205. [https://doi.org/10.1056/NEJMoa042040 link to original article] [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1016/S1470-2045%2806%2970664-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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 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. [https://doi.org/10.1016/S1470-2045%2811%2970235-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21940214 PubMed]
 
−
# '''ECOG E4494:''' 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. [https://doi.org/10.1200/jco.2005.05.1003 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16754935 PubMed] NCT00003150
 
−
# '''MISTRAL:''' Betticher DC, Martinelli G, Radford JA, Kaufmann M, Dyer MJ, Kaiser U, Aulitzky WE, Beck J, von Rohr A, Kovascovics T, Cogliatti SB, Cina S, Maibach R, Cerny T, Linch DC. Sequential high dose chemotherapy as initial treatment for aggressive sub-types of non-Hodgkin lymphoma: results of the international randomized phase III trial (MISTRAL). Ann Oncol. 2006 Oct;17(10):1546-52. Epub 2006 Aug 3. [https://doi.org/10.1093/annonc/mdl153 link to original article] [https://pubmed.ncbi.nlm.nih.gov/16888080 PubMed] NCT00003215
 
−
# 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. [https://doi.org/10.1200/JCO.2006.07.0722 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17228021 PubMed]
 
−
<!-- Presented orally and in abstract form at the 47th annual meeting of the American Society of Hematology, Atlanta, Georgia, December 11, 2005. -->
 
−
# '''HOVON-26:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17132720 PubMed]
 
−
# '''AGMT NHL-5:''' Fridrik MA, Hausmaninger H, Lang A, Drach J, Krieger O, Geissler D, Michlmayr G, Ulsperger E, Chott A, Oberaigner W, Greil R. Dose-dense therapy improves survival in aggressive non-Hodgkin's lymphoma. Ann Hematol. 2010 Mar;89(3):273-82. Epub 2009 Aug 20. [https://doi.org/10.1007/s00277-009-0811-x link to original article] [https://pubmed.ncbi.nlm.nih.gov/19693500 PubMed]
 
−
# '''JCOG 9809:''' Ohmachi K, Tobinai K, Kobayashi Y, Itoh K, Nakata M, Shibata T, Morishima Y, Ogura M, Suzuki T, Ueda R, Aikawa K, Nakamura S, Fukuda H, Shimoyama M, Hotta T; Lymphoma Study Group of the Japan Clinical Oncology Group. Phase III trial of CHOP-21 versus CHOP-14 for aggressive non-Hodgkin's lymphoma: final results of the Japan Clinical Oncology Group Study, JCOG 9809. Ann Oncol. 2011 Jun;22(6):1382-91. Epub 2010 Dec 31. [https://doi.org/10.1093/annonc/mdq619 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21196441 PubMed] NCT00133302
 
−
# '''SWOG S0313:''' Persky DO, Miller TP, Unger JM, Spier CM, Puvvada S, Stea BD, Press OW, Constine LS, Barton KP, Friedberg JW, LeBlanc M, Fisher RI. Ibritumomab consolidation after 3 cycles of CHOP plus radiotherapy in high-risk limited-stage aggressive B-cell lymphoma: SWOG S0313. Blood. 2015 Jan 8;125(2):236-41. Epub 2014 Nov 13. [http://www.bloodjournal.org/content/125/2/236.long link to original article] '''contains dosing details in manuscript''' [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287635/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/25395425 PubMed] NCT00070018
 
−
==CHOP-14 {{#subobject:6f7a21|Regimen=1}}==
 
−
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
 
−
<br>CHOP-14: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone every '''<u>14</u>''' days
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #1 {{#subobject:39e6ac|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.2003.06.137 Blayney et al. 2003 (SWOG 9349)]
 
−
|1994-1997
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day on days 2 to 11, or until ANC is greater than 10,000/uL
 
−
'''14-day cycle for up to 6 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #2 {{#subobject:d78eb4|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/109/7/2759.long Verdonck et al. 2007 (HOVON-26)]
 
−
|1994-2004
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP-21]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day on days 2 to 11
 
−
'''14-day cycle for 6 cycles'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #3 {{#subobject:22ca16|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|rowspan=2|[http://www.bloodjournal.org/content/104/3/626.long Pfreundschuh et al. 2004 (NHL-B1)]
 
−
|rowspan=2|1993-2000
 
−
|rowspan=2 style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOEP-14|CHOEP-14]]
 
−
|style="background-color:#d73027"|Inferior EFS
 
−
|-
 
−
|2. [[#CHOEP-21|CHOEP-21]]<br> 3. [[#CHOP|CHOP-21]]
 
−
|style="background-color:#91cf60"|Seems to have superior OS
 
−
|-
 
−
|rowspan=3|[https://doi.org/10.1016/S1470-2045%2808%2970002-0 Pfreundschuh et al. 2008 (RICOVER-60)]
 
−
|rowspan=3|2000-2005
 
−
|rowspan=3 style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[#CHOP-14|CHOP-14]] x 8
 
−
|style="background-color:#fc8d59"|Seems to have inferior EFS
 
−
|-
 
−
|2. [[Diffuse_large_B-cell_lymphoma#R-CHOP-14|R-CHOP-14]] x 6
 
−
|style="background-color:#d73027"|Inferior OS
 
−
|-
 
−
|3. [[Diffuse_large_B-cell_lymphoma#R-CHOP-14|R-CHOP-14]] x 8
 
−
|style="background-color:#d73027"|Inferior PFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#cbd5e8">
 
−
====Preceding treatment====
 
−
*[[Diffuse_large_B-cell_lymphoma#Vincristine_.26_Prednisone|Pre-phase vincristine & prednisone]] (recommended in NHL-B1 and mandatory in RICOVER-60)
 
−
</div>
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*(per Pfreundschuh et al. 2004):
 
−
*[[Filgrastim (Neupogen)]] 300 mcg (for patients  less than 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'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*Patients with "Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter of at least 7.5 cm or extranodal involvement": [[#Radiation_therapy|RT]], 36 Gy to areas of initial bulky disease
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #4 {{#subobject:23cb16|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|rowspan=3|[https://doi.org/10.1016/S1470-2045%2808%2970002-0 Pfreundschuh et al. 2008 (RICOVER-60)]
 
−
|rowspan=3|2000-2005
 
−
|rowspan=3 style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[#CHOP-14|CHOP-14]] x 6
 
−
|style="background-color:#91cf60"|Seems to have superior EFS
 
−
|-
 
−
|2. [[Diffuse_large_B-cell_lymphoma#R-CHOP-14|R-CHOP-14]] x 6
 
−
|style="background-color:#d3d3d3"|Not reported
 
−
|-
 
−
|3. [[Diffuse_large_B-cell_lymphoma#R-CHOP-14|R-CHOP-14]] x 8
 
−
|style="background-color:#d3d3d3"|Not reported
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#cbd5e8">
 
−
====Preceding treatment====
 
−
*[[Diffuse_large_B-cell_lymphoma#Vincristine_.26_Prednisone|Pre-phase vincristine & prednisone]]
 
−
</div>
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] 300 mcg (for patients less than 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'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*Patients with "Initial bulky disease": patients with "lymphoma masses or conglomerates with a diameter of at least 7.5 cm or extranodal involvement": [[#Radiation_therapy|RT]], 36 Gy to areas of initial bulky disease
 
−
</div></div>
 
−
===References===
 
−
# '''SWOG 9349:''' Blayney DW, LeBlanc ML, Grogan T, Gaynor ER, Chapman RA, Spiridonidis CH, Taylor SA, Bearman SI, Miller TP, Fisher RI; [[Study_Groups#SWOG|SWOG]]. 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. [https://doi.org/10.1200/jco.2003.06.137 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12829664 PubMed]
 
−
# '''NHL-B1:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/14982884 PubMed]
 
−
# '''NHL-B2:''' 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://pubmed.ncbi.nlm.nih.gov/15016643 PubMed]
 
−
<!-- Presented orally and in abstract form at the 47th annual meeting of the American Society of Hematology, Atlanta, Georgia, December 11, 2005. -->
 
−
# '''HOVON-26:''' 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/17132720 PubMed]
 
−
# '''RICOVER-60:''' 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. 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. [https://doi.org/10.1016/S1470-2045%2808%2970002-0 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/18226581 PubMed] NCT00052936
 
−
==CHOP Modified {{#subobject:bb947a|Regimen=1}}==
 
−
mCHOP: '''<u>m</u>'''odified '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:7b74fc|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199710303371802 Link et al. 1997]
 
−
|1983-1991
 
−
| style="background-color:#91cf61" |Non-randomized portion of RCT
 
−
|-
 
−
|}
 
−
''Note: This regimen has some major differences from standard CHOP.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV once per day on days 1, 22, 43
 
−
*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once per day on days 1, 22, 43
 
−
*[[Vincristine (Oncovin)]] 1.5 mg/m<sup>2</sup> IV once per day on days 1, 8, 15, 22, 29, 36, 43
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup>/day on days 1 to 28, 43 to 47
 
−
'''9-week course'''
 
−
</div></div>
 
−
===References===
 
−
# Link MP, Shuster JJ, Donaldson SS, Berard CW, Murphy SB. Treatment of children and young adults with early-stage non-Hodgkin's lymphoma. N Engl J Med. 1997 Oct 30;337(18):1259-66. [https://doi.org/10.1056/NEJM199710303371802 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9345074 PubMed]
 
  
−
==CHOP Modified (Prednisolone) {{#subobject:bb947|Regimen=1}}==
 
−
mCHOP: '''<u>m</u>'''odified '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisolone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:4f9502|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdg067 Bessell et al. 2003 (CLG NH 3003)]
 
−
|1993-2000
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#CNOP_.28Prednisolone.29|MCOP]]
 
−
|style="background-color:#d3d3d3"|Not designed to look at efficacy
 
−
|-
 
−
|}
 
−
''Note: This regimen is designed for elderly patients and is of lower intensity than standard CHOP.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]] 20 mg PO twice per day on days 1 to 5
 
−
'''21-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# '''CLG NH 3003:''' 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. [https://doi.org/10.1093/annonc/mdg067 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12562653 PubMed] NCT00002576
 
−
 
−
==CHOP-BCG {{#subobject:236052|Regimen=1}}==
 
−
CHOP-BCG: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>B</u>'''acillus '''<u>C</u>'''almette-'''<u>G</u>'''uérin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a81974|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|rowspan=2|[https://doi.org/10.1002/1097-0142%28197902%2943%3A2%3C417%3A%3AAID-CNCR2820430203%3E3.0.CO%3B2-I Jones et al. 1979]
 
−
|rowspan=2|1974-1977
 
−
|rowspan=2|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP-B|CHOP-B]]
 
−
| style="background-color:#d3d3d3" |Not reported
 
−
|-
 
−
|2. [[#COP-Bleo|COP-Bleo]]
 
−
| style="background-color:#d9ef8b" |Might have superior CR rate
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
====Immunotherapy====
 
−
*[[Bacillus Calmette-Guérin (BCG)]]
 
−
</div></div>
 
−
===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; [[Study_Groups#SWOG|SWOG]]. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. [https://doi.org/10.1002/1097-0142%28197902%2943%3A2%3C417%3A%3AAID-CNCR2820430203%3E3.0.CO%3B2-I link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/84706 PubMed]
 
−
## '''Update:''' Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Talley R, Butler JJ, Byrne GE Jr, Hartsock R, Dixon D, Salmon SE. Improved complete remission rates and survival for patients with large cell lymphoma treated with chemoimmunotherapy: a Southwest Oncology Group Study. Cancer. 1983 Mar 15;51(6):1083-90. [https://doi.org/10.1002/1097-0142(19830315)51:6%3C1083::aid-cncr2820510619%3E3.0.co;2-m link to original article] [https://pubmed.ncbi.nlm.nih.gov/6185212 PubMed]
 
−
==CHOP-B {{#subobject:015a69|Regimen=1}}==
 
−
CHOP-B: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>B</u>'''leomycin
 
−
<br>B-CHOP: '''<u>B</u>'''leomycin, '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<br>BACOP: '''<u>B</u>'''leomycin, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:2ae46d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/49/3/325.long Rodriguez et al. 1977]
 
−
|1973-1975
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[http://www.bloodjournal.org/content/49/5/759.long Skarin et al. 1977]
 
−
|1973-1975
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|rowspan=2|[https://doi.org/10.1002/1097-0142%28197902%2943%3A2%3C417%3A%3AAID-CNCR2820430203%3E3.0.CO%3B2-I Jones et al. 1979]
 
−
|rowspan=2|1974-1977
 
−
|rowspan=2 style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP-BCG|CHOP-BCG]]
 
−
| style="background-color:#d3d3d3" |Not reported
 
−
|-
 
−
|2. [[#COP-Bleo|COP-Bleo]]
 
−
| style="background-color:#d9ef8b" |Might have superior CR rate
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/6177407 Newcomer et al. 1982]
 
−
|NR in abstract
 
−
|style="background-color:#91cf61"|Randomized, <20 patients (E-de-esc)
 
−
|[[#ACOMLA|ACOMLA]]
 
−
|style="background-color:#91cf60"|Seems to have superior RFS
 
−
|-
 
−
|[https://doi.org/10.1016/0360-3016(88)90340-9 Bajetta et al. 1988]
 
−
|1976-1984
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CVP|CVP]]
 
−
|style="background-color:#91cf60"|Seems to have superior FFFP
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199312093292404 Meyer et al. 1993]
 
−
|1982-1989
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#eBACOP_99|esc-BACOP]]
 
−
|style="background-color:#ffffbf"|Did not meet efficacy endpoints
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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) IV once on day 1
 
−
*[[Bleomycin (Blenoxane)]] 4 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 8 cycles'''
 
−
</div></div>
 
−
===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://pubmed.ncbi.nlm.nih.gov/65189 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. [http://www.bloodjournal.org/content/49/5/759.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/66957 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; [[Study_Groups#SWOG|SWOG]]. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. [https://doi.org/10.1002/1097-0142%28197902%2943%3A2%3C417%3A%3AAID-CNCR2820430203%3E3.0.CO%3B2-I link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/84706 PubMed]
 
−
## '''Update:''' Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Talley R, Butler JJ, Byrne GE Jr, Hartsock R, Dixon D, Salmon SE. Improved complete remission rates and survival for patients with large cell lymphoma treated with chemoimmunotherapy: a Southwest Oncology Group Study. Cancer. 1983 Mar 15;51(6):1083-90. [https://doi.org/10.1002/1097-0142(19830315)51:6%3C1083::aid-cncr2820510619%3E3.0.co;2-m link to original article] [https://pubmed.ncbi.nlm.nih.gov/6185212 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. [https://pubmed.ncbi.nlm.nih.gov/6177407 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. [https://doi.org/10.1016/0360-3016(88)90340-9 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2455701 PubMed]
 
−
# Meyer RM, Quirt IC, Skillings JR, Cripps MC, Bramwell VH, Weinerman BH, Gospodarowicz MK, Burns BF, Sargeant AM, Shepherd LE, Zee B, Hryniuk WM. Escalated as compared with standard doses of doxorubicin in BACOP therapy for patients with non-Hodgkin's lymphoma. N Engl J Med. 1993 Dec 9;329(24):1770-6. [https://doi.org/10.1056/NEJM199312093292404 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7694148 PubMed]
 
−
==CHVP {{#subobject:15cj69|Regimen=1}}==
 
−
CHVP: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>V</u>'''umon (Teniposide), '''<u>P</u>'''rednisone
 
−
<br>CHVmP: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>Vm</u>'''26 (Teniposide), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:2acj5d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1016/0360-3016(83)90201-8 Burgers et al. 1983 (EORTC 20751)]
 
−
|1975-1980
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CVP|CVP]]
 
−
| style="background-color:#d3d3d3" |Not reported
 
−
|-
 
−
|[https://doi.org/10.1093/oxfordjournals.annonc.a057979 Carde et al. 1991]
 
−
|1980-1986
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHVmP-VB|CHVmP-VB]]
 
−
| style="background-color:#d73027" |Inferior OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Teniposide (Vumon)]] 60 mg/m<sup>2</sup> IV over 60 minutes once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
</div></div>
 
−
===References===
 
−
# '''EORTC 20751:''' Burgers JM, Somers R, Quasim MM, van Glabbekke M. Report on the EORTC 20751 lymphoma trial. Int J Radiat Oncol Biol Phys. 1983 Jan;9(1):11-5. [https://doi.org/10.1016/0360-3016(83)90201-8 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6341333 PubMed]
 
−
# Carde P, Meerwaldt JH, van Glabbeke M, Somers R, Monconduit M, Thomas J, de Wolf-Peeters C, de Pauw B, Tanguy A, Kluin-Nelemans JC, Noordijk EM, Regnier R, Bron D, Lustman-Marechal J, Caillou B, Bosq J, van Heerde P, van Unnik JAM, Burgers MV, Hayat M, Cosset JM, van der Schueren E, Wagener J, Hagenbeek A, Cattan A, Duez N, Tubiana M; [[Study_Groups#EORTC|EORTC]] Lymphoma Group. Superiority of second over first generation chemotherapy in a randomized trial for stage III-IV intermediate and high-grade non-Hodgkin's lymphoma (NHL): the 1980-1985 EORTC trial. Ann Oncol. 1991 Jun;2(6):431-5. [https://doi.org/10.1093/oxfordjournals.annonc.a057979 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/1722697 PubMed]
 
−
==CHVmP-VB {{#subobject:0a9c69|Regimen=1}}==
 
−
CHVmP-VB: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>Vm</u>'''26 (Teniposide), '''<u>P</u>'''rednisone, '''<u>V</u>'''incristine, '''<u>B</u>'''leomycin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:2jb46d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1093/oxfordjournals.annonc.a057979 Carde et al. 1991]
 
−
|1980-1986
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHVP|CHVP]]
 
−
| style="background-color:#1a9850" |Superior OS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/5.suppl_2.s85 Somers et al. 1994a]
 
−
|1986-1991
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ProMACE-MOPP|ProMACE-MOPP]]
 
−
| style="background-color:#d73027" |Inferior ORR
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Teniposide (Vumon)]] 60 mg/m<sup>2</sup> IV over 60 minutes once on day 1
 
−
*[[Vincristine (Oncovin)]] 2 mg IV once on day 15
 
−
*[[Bleomycin (Blenoxane)]] 10 mg IV once on day 15
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 40 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
</div></div>
 
−
===References===
 
−
# Carde P, Meerwaldt JH, van Glabbeke M, Somers R, Monconduit M, Thomas J, de Wolf-Peeters C, de Pauw B, Tanguy A, Kluin-Nelemans JC, Noordijk EM, Regnier R, Bron D, Lustman-Marechal J, Caillou B, Bosq J, van Heerde P, van Unnik JAM, Burgers MV, Hayat M, Cosset JM, van der Schueren E, Wagener J, Hagenbeek A, Cattan A, Duez N, Tubiana M; [[Study_Groups#EORTC|EORTC]] Lymphoma Group. Superiority of second over first generation chemotherapy in a randomized trial for stage III-IV intermediate and high-grade non-Hodgkin's lymphoma (NHL): the 1980-1985 EORTC trial. Ann Oncol. 1991 Jun;2(6):431-5. [https://doi.org/10.1093/oxfordjournals.annonc.a057979 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/1722697 PubMed]
 
−
# Somers R, Carde P, Thomas J, Tirelli U, Keuning JJ, Bron D, Delmer A, de Bock R, De Wolf-Peeters C, van Glabbeke M, Duez N; [[Study_Groups#EORTC|EORTC]]. EORTC study of non-Hodgkin's lymphoma: phase III study comparing CHVmP-VB and ProMACE-MOPP in patients with stage II, III, and IV intermediate- and high-grade lymphoma. Ann Oncol. 1994;5 Suppl 2:85-9. Erratum in: Ann Oncol 1994 May;5(5):475. [https://doi.org/10.1093/annonc/5.suppl_2.s85 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7515651 PubMed]
 
−
==C-MOPP {{#subobject:5c18a1|Regimen=1}}==
 
−
C-MOPP: '''<u>C</u>'''yclophospha'''<u>M</u>'''ide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone
 
−
<br>COPP: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a3fc4e|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 80%; text-align:center;"
 
−
!style="width: 25%"|Study
 
−
!style="width: 25%"|Years of enrollment
 
−
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1016/s0140-6736(75)91142-3 DeVita et al. 1975]
 
−
|1965-1972
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.7326/0003-4819-81-5-601 Stein et al. 1974]
 
−
|1970-1973
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|Vincristine & Prednisone (VP)
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Procarbazine (Matulane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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. [https://doi.org/10.7326/0003-4819-81-5-601 link to original article] [https://pubmed.ncbi.nlm.nih.gov/4608355 PubMed]
 
−
# 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://doi.org/10.1016/s0140-6736(75)91142-3 link to original article] [https://pubmed.ncbi.nlm.nih.gov/46388 PubMed]
 
−
==CNOP {{#subobject:3121b4|Regimen=1}}==
 
−
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
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:4a0ab|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1971727/ Sonneveld & Michiels 1990]
 
−
|NR
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1093/oxfordjournals.annonc.a058153 Pavlovsky et al. 1992a]
 
−
|1985-1988
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#CHOP|CHOP]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 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)]] 1.4 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 50 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''28-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===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. [https://doi.org/10.1038/bjc.1990.238 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1971727/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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, Milone G. 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. [https://doi.org/10.1093/oxfordjournals.annonc.a058153 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1586618 PubMed]
 
−
## '''Update:''' Bezwoda W, Rastogi RB, Erazo Valla A, Diaz-Maqueo JC, Pavlovsky S, Morioka H, Resegotti L, Rueckle H, Somoza N, Moreno-Nogueira JA, Bernasconi C, Ho A, Burns I, Lardinois J, van der Merwe A, Richards E; Novantrone International Study Group. Long-term results of a multicentre randomised, comparative phase III trial of CHOP versus CNOP regimens in patients with intermediate- and high-grade non-Hodgkin's lymphomas. Eur J Cancer. 1995 Jun;31A(6):903-11. [https://doi.org/10.1016/0959-8049(95)00076-3 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7646919 PubMed]
 
−
==CNOP (Prednisolone) {{#subobject:3525b4|Regimen=1}}==
 
−
CNOP: '''<u>C</u>'''yclophosphamide, '''<u>N</u>'''ovantrone (Mitoxantrone), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisolone
 
−
<br>MCOP: '''<u>M</u>'''itoxantrone, '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisolone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:85jbab|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdg067 Bessell et al. 2003 (CLG NH 3003)]
 
−
|1993-2000
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#CHOP_Modified_.28Prednisolone.29|Modified CHOP]]
 
−
|style="background-color:#d3d3d3"|Not designed to look at efficacy
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====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
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]] 20 mg PO twice per day on days 1 to 5
 
−
'''21-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# '''CLG NH 3003:''' 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. [https://doi.org/10.1093/annonc/mdg067 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12562653 PubMed] NCT00002576
 
−
==COMP {{#subobject:97155c|Regimen=1}}==
 
−
COMP: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>M</u>'''ethotrexate, '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a2c727|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM198303103081003 Anderson et al. 1983]
 
−
|1977-1979
 
−
|style="background-color:#1a9851"|Phase 3 (E-de-esc)
 
−
|[[#LSA2-L2_88|LSA<sub>2</sub>-L<sub>2</sub>]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of FFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 1200 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 2 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once per day on days 3, 10, 17, 24
 
−
*[[Methotrexate (MTX)]] 180 mg/m<sup>2</sup> IV push, then 120 mg/m<sup>2</sup> IV over 4 hours once on day 12
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 15 mg/m<sup>2</sup> (maximum dose of 60 mg/day) PO four times per day on days 3 to 30, then taper off on days 31 to 37
 
−
====CNS therapy, prophylaxis====
 
−
*[[Methotrexate (MTX)]] 6.25 mg/m<sup>2</sup> IT once per day on days 5, 31, 34
 
−
'''One course'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*[[#COMP_88|COMP]] maintenance
 
−
</div></div>
 
−
===References===
 
−
# Anderson JR, Wilson JF, Jenkin DT, Meadows AT, Kersey J, Chilcote RR, Coccia P, Exelby P, Kushner J, Siegel S, Hammond D. Childhood non-Hodgkin's lymphoma: the results of a randomized therapeutic trial comparing a 4-drug regimen (COMP) with a 10-drug regimen (LSA2-L2). N Engl J Med. 1983 Mar 10;308(10):559-65. [https://doi.org/10.1056/NEJM198303103081003 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/6338381 PubMed]
 
−
==COP-Bleo {{#subobject:303d31|Regimen=1}}==
 
−
COP-Bleo: '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>Bleo</u>'''mycin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:241a27|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/71206 Coltman et al. 1977]
 
−
|1966-1974
 
−
| style="background-color:#91cf61" |Non-randomized
 
−
| style="background-color:#d3d3d3" |
 
−
| style="background-color:#d3d3d3" |
 
−
|-
 
−
|[https://doi.org/10.1002/1097-0142%28197902%2943%3A2%3C417%3A%3AAID-CNCR2820430203%3E3.0.CO%3B2-I Jones et al. 1979]
 
−
|1974-1977
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[#CHOP-BCG|CHOP-BCG]]<br>2. [[#CHOP-B|CHOP-B]]
 
−
| style="background-color:#fee08b" |Might have inferior CR rate
 
−
|-
 
−
|}
 
−
''Note: to our knowledge, this regimen was not tested as an experimental arm in a RCT prior to becoming a standard comparator arm.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===References===
 
−
# Coltman CA Jr, Luce JK, McKelvey EM, Jones SE, Moon TE; [[Study_Groups#SWOG|SWOG]]. Chemotherapy of non-Hodgkin's lymphoma: 10 years' experience in the Southwest Oncology Group. Cancer Treat Rep. 1977 Sep;61(6):1067-78. [https://pubmed.ncbi.nlm.nih.gov/71206 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; [[Study_Groups#SWOG|SWOG]]. Superiority of adriamycin-containing combination chemotherapy in the treatment of diffuse lymphoma: a Southwest Oncology Group study. Cancer. 1979 Feb;43(2):417-25. [https://doi.org/10.1002/1097-0142%28197902%2943%3A2%3C417%3A%3AAID-CNCR2820430203%3E3.0.CO%3B2-I link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/84706 PubMed]
 
−
## '''Update:''' Jones SE, Grozea PN, Metz EN, Haut A, Stephens RL, Morrison FS, Talley R, Butler JJ, Byrne GE Jr, Hartsock R, Dixon D, Salmon SE. Improved complete remission rates and survival for patients with large cell lymphoma treated with chemoimmunotherapy: a Southwest Oncology Group Study. Cancer. 1983 Mar 15;51(6):1083-90. [https://doi.org/10.1002/1097-0142(19830315)51:6%3C1083::aid-cncr2820510619%3E3.0.co;2-m link to original article] [https://pubmed.ncbi.nlm.nih.gov/6185212 PubMed]
 
−
==CVP {{#subobject:236441|Regimen=1}}==
 
−
CVP: '''<u>C</u>'''yclophosphamide, '''<u>V</u>'''incristine, '''<u>P</u>'''rednisone
 
−
<br>COP:  '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<br>VCP: '''<u>V</u>'''incristine, '''<u>C</u>'''yclophosphamide, '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:527252|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/33/2/370.short Hoogstraten et al. 1969]
 
−
|NR
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|Cyclophosphamide
 
−
| style="background-color:#1a9850" |Superior CR rate
 
−
|-
 
−
|[https://doi.org/10.7326/0003-4819-76-2-227 Bagley et al. 1972]
 
−
|1967-1970
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1002/1097-0142(197611)38:5%3C1896::AID-CNCR2820380505%3E3.0.CO;2-Z Benjamin et al. 1976]
 
−
|1970-1973
 
−
|style="background-color:#91cf61"|Randomized, <20 pts (E-de-esc)
 
−
|[[#MOPP_88|MOPP]]
 
−
|style="background-color:#d3d3d3"|Not reported
 
−
|-
 
−
|[https://doi.org/10.1002/mpo.2950030110 Monfardini et al. 1977]
 
−
|1972-1974
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ABP|ABP]]
 
−
|style="background-color:#ffffbf"|Did not meet endpoint of ORR
 
−
|-
 
−
|[https://doi.org/10.1016/0360-3016(88)90340-9 Bajetta et al. 1988]
 
−
|1976-1984
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#CHOP-B|BACOP]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior FFFP
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 1000 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 1.4 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg/m<sup>2</sup> PO once per day on days 1 to 5
 
−
'''21-day cycles'''
 
−
</div></div>
 
−
===References===
 
−
# Hoogstraten B, Owens AH, Lenhard RE, Glidewell OJ, Leone LA, Olson KB, Harley JB, Townsend SR, Miller S, Spurr CL. Combination chemotherapy in lymphosarcoma and reticulum cell sarcoma. Blood. 1969 Feb;33(2):370-8. [http://www.bloodjournal.org/content/33/2/370.short link to original article] [https://pubmed.ncbi.nlm.nih.gov/4886120 PubMed]
 
−
# 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. [https://doi.org/10.7326/0003-4819-76-2-227 link to original article] [https://pubmed.ncbi.nlm.nih.gov/5066691 PubMed]
 
−
# Benjamin RS, Wiernik PH, O'Connell MJ, Chang P, Sutherland JC. A comparison of cyclophosphamide, vincristine, and prednisone (COP) with nitrogen mustard, vincristine, procarbazine, and prednisone (MOPP) in the treatment of nodular, poorly differentiated, lymphocytic lymphoma. Cancer. 1976 Nov;38(5):1896-902. [https://doi.org/10.1002/1097-0142(197611)38:5%3C1896::AID-CNCR2820380505%3E3.0.CO;2-Z link to original article] [https://pubmed.ncbi.nlm.nih.gov/1036467 PubMed]
 
−
# Monfardini S, Tancini G, De Lena 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://doi.org/10.1002/mpo.2950030110 link to original article] [https://pubmed.ncbi.nlm.nih.gov/65728 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. [https://doi.org/10.1016/0360-3016(88)90340-9 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2455701 PubMed]
 
−
==DA-EPOCH {{#subobject:9b4e41|Regimen=1}}==
 
−
DA-EPOCH: '''<u>D</u>'''ose '''<u>A</u>'''djusted '''<u>E</u>'''toposide, '''<u>P</u>'''rednisone, '''<u>O</u>'''ncovin (Vincristine), '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:263b57|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/99/8/2685.long Wilson et al. 2002]
 
−
|1993-1999
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]] 50 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1 (total dose per cycle: 200 mg/m<sup>2</sup>)
 
−
*[[Vincristine (Oncovin)]] 0.4 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1 (total dose per cycle: 1.6 mg/m<sup>2</sup>)
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV over 15 minutes once on day 5
 
−
*[[Doxorubicin (Adriamycin)]] 10 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1 (total dose per cycle: 40 mg/m<sup>2</sup>)
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO twice per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day 6 and continuing until ANC greater than 5000/uL past nadir
 
−
*PCP prophylaxis with ONE of the following:
 
−
**[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO twice per day 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 modifications====
 
−
*Start cycle 1 as described above.
 
−
*Obtain CBCs twice per week for nadir measurements.
 
−
*If nadir ANC greater than 500/uL, increase etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
 
−
*If nadir ANC less than 500/uL on 1 or 2 measurements, use same doses as last cycle.
 
−
*If nadir ANC less than 500/uL on at least 3 measurements, decrease etoposide, doxorubicin, and cyclophosphamide by 20% compared to previous cycle.
 
−
*And/or if nadir platelet count less than 25 x 10<sup>9</sup>/L 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 greater than 1000/uL and platelets greater than 100 x 10<sup>9</sup>/L.  If counts are below those levels, check daily CBC and continue growth factor support until counts are adequate and next cycle can start.
 
−
</div></div>
 
−
===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. [http://www.bloodjournal.org/content/99/8/2685.long link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/11929754 PubMed]
 
−
==DICEP {{#subobject:b2b482|Regimen=1}}==
 
−
DICEP: '''<u>D</u>'''ose '''<u>I</u>'''ntensive '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>P</u>'''latinol (Cisplatin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:aa3d2e|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/107/12/4623.long Stewart et al. 2006]
 
−
|1998-2004
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#cbd5e8">
 
−
====Preceding treatment====
 
−
*[[#CHOP|CHOP]] x 1
 
−
</div>
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Cisplatin (Platinol)]]
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*[[#BEAM.2C_then_auto_HSCT_88|BEAM, then auto HSCT]]
 
−
</div></div>
 
−
===References===
 
−
# Stewart DA, Bahlis N, Valentine K, Balogh A, Savoie L, Morris DG, Jones A, Brown C, Russell JA. Upfront double high-dose chemotherapy with DICEP followed by BEAM and autologous stem cell transplantation for poor-prognosis aggressive non-Hodgkin lymphoma. Blood. 2006 Jun 15;107(12):4623-7. Epub 2006 Feb 7. [http://www.bloodjournal.org/content/107/12/4623.long link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/16467197 PubMed] content property of [http://hemonc.org HemOnc.org]
 
−
==F-MACHOP {{#subobject:425e33|Regimen=1}}==
 
−
F-MACHOP: '''<u>F</u>'''luorouracil, '''<u>M</u>'''ethotrexate, '''<u>A</u>'''ra-C (Cytarabine), '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:c378e6|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/4012340 Amadori et al. 1985]
 
−
|NR in abstract
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|-
 
−
|[http://www.haematologica.org/content/81/6/521.long Infanti et al. 1996]
 
−
|1991-1996
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Fluorouracil (5-FU)]]
 
−
*[[Methotrexate (MTX)]]
 
−
*[[Cytarabine (Ara-C)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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://pubmed.ncbi.nlm.nih.gov/4012340 PubMed]
 
−
## '''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. [https://doi.org/10.3109/07357908709011732 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3651863 PubMed]
 
−
## '''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. [https://pubmed.ncbi.nlm.nih.gov/3589684 PubMed]
 
−
## '''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. [https://doi.org/10.1093/oxfordjournals.annonc.a057958 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1954181 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. [http://www.haematologica.org/content/81/6/521.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/9009439 PubMed]
 
−
==HOP {{#subobject:f63e46|Regimen=1}}==
 
−
HOP: '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<br>APO: '''<u>A</u>'''driamycin (Doxorubicin), '''<u>P</u>'''rednisone, '''<u>O</u>'''ncovin (Vincristine)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:e5509d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1002/1097-0142(197610)38:4%3C1484::aid-cncr2820380407%3E3.0.co;2-i McKelvey et al. 1976]
 
−
|1972-1974
 
−
|style="background-color:#1a9851"|Phase 3 (E-de-esc)
 
−
|[[#CHOP|CHOP]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.3109/10428190109064597 Laver et al. 2001 (POG 8615)]
 
−
|1986-1991
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#ACOP_99|ACOP]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of EFS
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.2005.11.075 Laver et al. 2005 (POG 9315)]
 
−
|1994-2000
 
−
| style="background-color:#91cf61" |Non-randomized portion of RCT
 
−
| style="background-color:#d3d3d3" |
 
−
| style="background-color:#d3d3d3" |
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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://doi.org/10.1002/1097-0142(197610)38:4%3C1484::aid-cncr2820380407%3E3.0.co;2-i link to original article] [https://pubmed.ncbi.nlm.nih.gov/791473 PubMed]
 
−
# '''POG 8615:''' Laver JH, Mahmoud H, Pick TE, Hutchinson RE, Weinstein HJ, Schwenn M, Weitzman S, Murphy SB, Ochoa S, Shuster JJ; Pediatric Oncology Group. Results of a randomized phase III trial in children and adolescents with advanced stage diffuse large cell non Hodgkin's lymphoma: a Pediatric Oncology Group study. Leuk Lymphoma. 2001 Jul;42(3):399-405. [https://doi.org/10.3109/10428190109064597 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11699405 PubMed]
 
−
# '''POG 9315:''' Laver JH, Kraveka JM, Hutchison RE, Chang M, Kepner J, Schwenn M, Tarbell N, Desai S, Weitzman S, Weinstein HJ, Murphy SB. Advanced-stage large-cell lymphoma in children and adolescents: results of a randomized trial incorporating intermediate-dose methotrexate and high-dose cytarabine in the maintenance phase of the APO regimen: a Pediatric Oncology Group phase III trial. J Clin Oncol. 2005 Jan 20;23(3):541-7. [https://doi.org/10.1200/JCO.2005.11.075 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15659500 PubMed] NCT00002618
 
−
==LD-ACOP-B {{#subobject:72a974|Regimen=1}}==
 
−
LD-ACOP-B: '''<u>L</u>'''ow-'''<u>D</u>'''ose '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>B</u>'''leomycin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:6eb553|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1991.9.5.741 O'Reilly et al. 1991]
 
−
|1983-1985
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1991.9.5.741 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1707954 PubMed]
 
−
==MACOP-B {{#subobject:ee1449|Regimen=1}}==
 
−
MACOP-B: '''<u>M</u>'''ethotrexate, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>B</u>'''leomycin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:de7d83|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/2580468 Klimo et al. 1985a]
 
−
|1981-1984
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 
−
|1986-1991
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP|CHOP]]<br>2. [[#m-BACOD|m-BACOD]]<br> 3. [[#ProMACE-CytaBOM|ProMACE-CytaBOM]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1994.12.7.1366 Sertoli et al. 1994]
 
−
|1987-1991
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#ProMACE-MOPP|ProMACE-MOPP]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS36
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199705013361804 Gianni et al. 1997]
 
−
|1987-NR
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|High-dose sequential therapy
 
−
| style="background-color:#d73027" |Inferior EFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Methotrexate (MTX)]] 400 mg/m<sup>2</sup> IV once per week on weeks 2, 6, 10
 
−
*[[Doxorubicin (Adriamycin)]] 50 mg/m<sup>2</sup> 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/m<sup>2</sup> IV once per week on weeks 2, 4, 6, 8, 10, 12
 
−
*[[Bleomycin (Blenoxane)]] 10 units/m<sup>2</sup> IV once per week on weeks 4, 8, 12
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 75 mg PO once per day, tapered over last 15 days (schedule not reported)
 
−
====CNS therapy, prophylaxis====
 
−
*(for patients with bone marrow involvement):
 
−
*[[Methotrexate (MTX)]] 12 mg IV
 
−
====Supportive therapy====
 
−
*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] 2 tablets (not specified if SS or DS) PO twice per day
 
−
'''12-week course'''
 
−
</div></div>
 
−
===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. [https://doi.org/10.7326/0003-4819-102-5-596 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2580468 PubMed]
 
−
## '''Update:''' Klimo P, Connors JM. Updated clinical experience with MACOP-B. Semin Hematol. 1987 Apr;24(2 Suppl 1):26-34. [https://pubmed.ncbi.nlm.nih.gov/2438779 PubMed]
 
−
# '''SWOG-8516:''' 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. [https://doi.org/10.1056/NEJM199304083281404 link to original article] [https://pubmed.ncbi.nlm.nih.gov/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://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1200/jco.2008.16.8021 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4879698/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19047289 PubMed]
 
−
# Sertoli MR, Santini G, Chisesi T, Congiu AM, Rubagotti A, Contu A, Salvagno L, Coser P, Porcellini A, Vespignani M, Capnist G, Rossi E, Mangoni L, Fabris P, Vinante O, Tedeschi L, Endrizzi L, Miglio LP, Perrotta A, Rosso R, Damasio E, Rizzoli V. 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. [https://doi.org/10.1200/jco.1994.12.7.1366 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7517442 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. [https://doi.org/10.1056/NEJM199705013361804 link to original article] [https://pubmed.ncbi.nlm.nih.gov/9113932 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. [https://doi.org/10.1016/S1470-2045%2806%2970664-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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 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. [https://doi.org/10.1016/S1470-2045%2811%2970235-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21940214 PubMed]
 
−
==m-BACOD {{#subobject:c52d3a|Regimen=1}}==
 
−
m-BACOD: '''<u>m</u>'''ethotrexate (moderate dose), '''<u>B</u>'''leomycin, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>D</u>'''examethasone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:7a2f2d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1983.1.2.91 Skarin et al. 1983]
 
−
|1976-1981
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1990.8.1.84 Shipp et al. 1990]
 
−
|1981-1986
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/1701924 Gherlinzoni et al. 1990]
 
−
|1984-1986
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#m-BNCOD|m-BNCOD]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoints of OS/RFS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199211053271903 Gordon et al. 1992]
 
−
|1984-1988
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 
−
|1986-1991
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP|CHOP]]<br>2. [[#MACOP-B|MACOP-B]]<br> 3. [[#ProMACE-CytaBOM|ProMACE-CytaBOM]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS
 
−
|-
 
−
|[https://doi.org/10.1200/jco.2000.18.6.1309 Tilly et al. 2000 (LNH87-1)]
 
−
|1987-1993
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ACVBP|ACVBP]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of FFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Methotrexate (MTX)]] 200 mg/m<sup>2</sup> IV once per day on days 8 & 15
 
−
*[[Bleomycin (Blenoxane)]] 4 units/m<sup>2</sup> IV once on day 1
 
−
*[[Doxorubicin (Adriamycin)]] 45 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cyclophosphamide (Cytoxan)]] 600 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Vincristine (Oncovin)]] 1 mg/m<sup>2</sup> (maximum dose of 2 mg) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]] 6 mg/m<sup>2</sup> (no route specified) once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*[[Folinic acid (Leucovorin)]] 10 mg/m<sup>2</sup> IV or PO every 6 hours on days 9 & 10, 16 & 17, starting 24 hours after each [[Methotrexate (MTX)]]
 
−
'''21-day cycle for 10 cycles'''
 
−
====Dose modifications====
 
−
*If nadir WBC <1,000 or nadir platelets less than 50,000: 50% of cyclophosphamide and doxorubicin
 
−
*If WBC <1,000, platelets less than 50,000, or creatinine >50% of baseline on day of treatment, methotrexate was omitted
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1983.1.2.91 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6199472 PubMed]
 
−
# Gherlinzoni F, Guglielmi C, Mazza P, Amadori S, Mandelli F, Tura S. Phase III comparative trial (m-BACOD v m-BNCOD) in the treatment of stage II to IV non-Hodgkin's lymphomas with intermediate- or high-grade histology. Semin Oncol. 1990 Dec;17(6 Suppl 10):3-8; discussion 8-9. [https://pubmed.ncbi.nlm.nih.gov/1701924 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. [https://doi.org/10.1200/jco.1990.8.1.84 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/1688615 PubMed]
 
−
# Gordon LI, Harrington D, Andersen J, Colgan J, Glick J, Neiman R, Mann R, Resnick GD, Barcos M, Gottlieb A, O'Connell M. Comparison of a second-generation combination chemotherapeutic regimen (m-BACOD) with a standard regimen (CHOP) for advanced diffuse non-Hodgkin's lymphoma. N Engl J Med. 1992 Nov 5;327(19):1342-9. [https://doi.org/10.1056/NEJM199211053271903 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1383819 PubMed]
 
−
# '''SWOG 8516:''' 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. [https://doi.org/10.1056/NEJM199304083281404 link to original article] [https://pubmed.ncbi.nlm.nih.gov/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://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1200/jco.2008.16.8021 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4879698/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19047289 PubMed]
 
−
# '''LNH87-1:''' Tilly H, Mounier N, Lederlin P, Brière J, Dupriez B, Sebban C, Bosly A, Biron P, Nouvel C, Herbrecht R, Bordessoule D, Coiffier B; Groupe d'Etude des Lymphomes de l'Adulte. Randomized comparison of ACVBP and m-BACOD in the treatment of patients with low-risk aggressive lymphoma: the LNH87-1 study. J Clin Oncol. 2000 Mar;18(6):1309-15. [https://doi.org/10.1200/jco.2000.18.6.1309 link to original article] [https://pubmed.ncbi.nlm.nih.gov/10715302 PubMed]
 
−
==m-BNCOD {{#subobject:e28311|Regimen=1}}==
 
−
m-BNCOD: '''<u>m</u>'''ethotrexate (moderate dose), '''<u>B</u>'''leomycin, '''<u>N</u>'''ovantrone (Mitoxantrone), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>D</u>'''examethasone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:dd1012|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/1701924 Gherlinzoni et al. 1990]
 
−
|1984-1986
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#m-BACOD|m-BACOD]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoints of OS/RFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Methotrexate (MTX)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
*[[Mitoxantrone (Novantrone)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]]
 
−
</div></div>
 
−
===References===
 
−
# Gherlinzoni F, Guglielmi C, Mazza P, Amadori S, Mandelli F, Tura S. Phase III comparative trial (m-BACOD v m-BNCOD) in the treatment of stage II to IV non-Hodgkin's lymphomas with intermediate- or high-grade histology. Semin Oncol. 1990 Dec;17(6 Suppl 10):3-8; discussion 8-9. [https://pubmed.ncbi.nlm.nih.gov/1701924 PubMed]
 
−
==P/DOCE {{#subobject:375d4a|Regimen=1}}==
 
−
P/DOCE: '''<u>P</u>'''rednisone, '''<u>D</u>'''oxorubicin, '''<u>O</u>'''ncovin (Vincristine), '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide,
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:6972b2|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1993.11.11.2250 O'Reilly et al. 1993]
 
−
|1988-1991
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
''Note: 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).''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 50 mg/day PO on days 1 to 10, 28 to 37, 49 to 58
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]] 40 mg/m<sup>2</sup> IV once per week on weeks 1, 2, 7, 8
 
−
*[[Vincristine (Oncovin)]] 1.2 mg/m<sup>2</sup> 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/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'''
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1993.11.11.2250 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/8229141 PubMed]
 
−
 
−
==PACEBOM {{#subobject:b78c96|Regimen=1}}==
 
−
PACEBOM: '''<u>P</u>'''rednisolone, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>B</u>'''leomycin, '''<u>O</u>'''ncovin (Vincristine), '''<u>M</u>'''ethotrexate
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:5b3956|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/11.suppl_1.S87 Linch et al. 2000]
 
−
|1987-1991
 
−
| style="background-color:#1a9851" |Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP]]
 
−
| style="background-color:#d9ef8b" |Might have superior cause-specific survival
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]]
 
−
====Chemotherapy====
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Methotrexate (MTX)]]
 
−
</div></div>
 
−
===References===
 
−
# Linch DC, Smith P, Hancock BW, Hoskin PJ, Cunningham DC, Newland AC, Milligan D, Stevenson PA, Wood JK, Maclennan KA, Vaughan B, Vaughan G, Gregory WM; British National Lymphoma Investigation. A randomized British National Lymphoma Investigation trial of CHOP vs a weekly multi-agent regimen (PACEBOM) in patients with histologically aggressive non-Hodgkin's lymphoma. Ann Oncol. 2000;11 Suppl 1:87-90. [https://doi.org/10.1093/annonc/11.suppl_1.S87 link to original article] [https://pubmed.ncbi.nlm.nih.gov/10707786 PubMed]
 
−
==PEN {{#subobject:d26134|Regimen=1}}==
 
−
PEN: '''<u>P</u>'''rednisone, '''<u>E</u>'''toposide, '''<u>N</u>'''ovantrone (Mitoxantrone)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a5253e|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.3109/10428199509064935 Goss et al. 1995]
 
−
|1991-1993
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Mitoxantrone (Novantrone)]]
 
−
</div></div>
 
−
===References===
 
−
# Goss P, Burkes R, Rudinskas L, King M, Chow W, Myers R, Davidson M, Poldre P, Crump M, Sutton D, Scott G. 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. [https://doi.org/10.3109/10428199509064935 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8580817 PubMed]
 
−
==PMitCEBO {{#subobject:6b10e7|Regimen=1}}==
 
−
PMitCEBO: '''<u>P</u>'''rednisolone, '''<u>Mit</u>'''oxantrone, '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>B</u>'''leomycin, '''<u>O</u>'''ncovin (Vincristine)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:8b4d2d|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/97/10/2991.long Mainwaring et al. 2001]
 
−
|1993-1997
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#PAdriaCEBO_88|PAdriaCEBO]]
 
−
| style="background-color:#1a9850" |Superior OS
 
−
|-
 
−
|[https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3216418/ Burton et al. 2006 (BNLI CHOPVPMITCEBO-GOODRISK)]
 
−
|1997-1999
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#CHOP|CHOP]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of FFS
 
−
|-
 
−
|[https://doi.org/10.1016/S1470-2045%2806%2970664-7 Pfreundschuh et al. 2006 (NCIC-CTG LY.9)]
 
−
|2000-2003
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|1. [[Diffuse_large_B-cell_lymphoma#R-CHOP|R-CHOP]]<br>2. [[#R-CHOEP_88|R-CHOEP]]<br>3. [[#R-MACOP-B_88|R-MACOP-B]]<br>4. [[#R-PMitCEBO_88|R-PMitCEBO]]
 
−
|style="background-color:#d73027"|Inferior EFS<sup>1</sup>
 
−
|-
 
−
|}
 
−
''<sup>1</sup>Reported efficacy is based on the 2011 update.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]]
 
−
====Chemotherapy====
 
−
*[[Mitoxantrone (Novantrone)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
</div></div>
 
−
===References===
 
−
# Mainwaring PN, Cunningham D, Gregory W, Hoskin P, Hancock B, Norton AJ, MacLennan K, Smith P, Vaughan Hudson G, Linch D. Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO. Blood. 2001 May 15;97(10):2991-7. [http://www.bloodjournal.org/content/97/10/2991.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/11342422 PubMed]
 
−
# '''BNLI CHOPVPMITCEBO-GOODRISK:''' 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. [https://doi.org/10.1038/sj.bjc.6602975 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3216418/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/16508640 PubMed] NCT00005867
 
−
#'''NCIC-CTG LY.9:''' 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. [https://doi.org/10.1016/S1470-2045%2806%2970664-7 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/16648042 PubMed] NCT00064116
 
−
## '''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 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. [https://doi.org/10.1016/S1470-2045%2811%2970235-2 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/21940214 PubMed]
 
−
==ProMACE-CytaBOM {{#subobject:5285e6|Regimen=1}}==
 
−
ProMACE-CytaBOM: '''<u>Pro</u>'''lix (Prednisone), '''<u>M</u>'''ethotrexate, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>Cyta</u>'''rabine, '''<u>B</u>'''leomycin, '''<u>O</u>'''ncovin (Vincristine), '''<u>M</u>'''ethotrexate
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:37d27b|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1991.9.1.25 Longo et al. 1991]
 
−
|1981-1988
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#ProMACE-MOPP|ProMACE-MOPP]]
 
−
| style="background-color:#91cf60" |Seems to have superior OS
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199304083281404 Fisher et al. 1993 (SWOG-8516/Intergroup 0067)]
 
−
|1986-1991
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|1. [[#CHOP|CHOP]]<br>2. [[#MACOP-B|MACOP-B]]<br> 3. [[#m-BACOD|m-BACOD]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)|Prednisone (Prolix)]] 60 mg/m<sup>2</sup> PO once per day on days 1 to 14
 
−
====Chemotherapy====
 
−
*[[Methotrexate (MTX)]] 120 mg/m<sup>2</sup> IV once on day 8
 
−
*[[Doxorubicin (Adriamycin)]] 25 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cyclophosphamide (Cytoxan)]] 650 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Etoposide (Vepesid)]] 120 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Cytarabine (Ara-C)]] 300 mg/m<sup>2</sup> 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 therapy====
 
−
*[[Folinic acid (Leucovorin)]] 25 mg/m<sup>2</sup> PO every 6 hours on day 9, starting 24 hours after [[Methotrexate (MTX)]]
 
−
*[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO twice per day throughout the course of treatment
 
−
====Dose modifications====
 
−
*"If WBC count is at least 4 x 10<sup>9</sup>/L, use 100% doses of all drugs
 
−
*If WBC count is 3 to 3.999 x 10<sup>9</sup>/L, 100% prednisone, bleomycin, vincristine, cytarabine, and methotrexate; 75% cyclophosphamide, doxorubicin, and etoposide
 
−
*If WBC count is 2 to 2.999 x 10<sup>9</sup>/L, 100% prednisone, bleomycin, vincristine, and methotrexate; 75% etoposide, cytarabine; 50% cyclophosphamide, doxorubicin
 
−
*If WBC count is 1 to 1.999 x 10<sup>9</sup>/L, 100% prednisone, bleomycin, vincristine and methotrexate; 25% cyclophosphamide, doxorubicin, etoposide, and cytarabine
 
−
*If WBC count is 0 to 0.999 x 10<sup>9</sup>/L, 100% prednisone, vincristine, and bleomycin; 50% methotrexate, no other drugs
 
−
*If platelet count is at least 100 x 10<sup>9</sup>/L, use 100% doses of all drugs
 
−
*If platelet count is 50 to 99 x 10<sup>9</sup>/L, 100% prednisone, bleomycin, vincristine, and methotrexate; 50% etoposide and cytarabine; 25% cyclophosphamide and doxorubicin
 
−
*If platelet count is 0 to 49 x 10<sup>9</sup>/L, 100% prednisone, bleomycin, and vincristine; 50% methotrexate, no other drugs"
 
−
====CNS therapy, prophylaxis====
 
−
*Patients with initial bone or bone marrow involvement who achieved a CR were treated with 2400 cGy prophylactic cranial irradiation.
 
−
'''21-day cycle for 6 cycles or 2 cycles after maximum clinical response'''
 
−
</div></div>
 
−
===References===
 
−
# Longo DL, DeVita VT Jr, Duffey PL, Wesley MN, Ihde DC, Hubbard SM, Gilliom M, Jaffe ES, Cossman J, Fisher RI, Young RC. 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. [https://doi.org/10.1200/jco.1991.9.1.25 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/1702144 PubMed]
 
−
# '''SWOG-8516:''' 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. [https://doi.org/10.1056/NEJM199304083281404 link to original article] [https://pubmed.ncbi.nlm.nih.gov/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://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1200/jco.2008.16.8021 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/pmc4879698/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/19047289 PubMed]
 
−
==ProMACE-MOPP {{#subobject:0aa31b|Regimen=1}}==
 
−
ProMACE-MOPP: '''<u>Pro</u>'''lix (Prednisone), '''<u>M</u>'''ethotrexate, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>M</u>'''ustargen (Mechlorethamine), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:cf90b9|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.7326/0003-4819-98-3-304 Fisher et al. 1983]
 
−
|1977-1981
 
−
| style="background-color:#91cf61" |Non-randomized
 
−
| style="background-color:#d3d3d3" |
 
−
| style="background-color:#d3d3d3" |
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1991.9.1.25 Longo et al. 1991]
 
−
|1981-1988
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#ProMACE-CytaBOM|ProMACE-CytaBOM]]
 
−
| style="background-color:#fc8d59" |Seems to have inferior OS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/5.suppl_2.s85 Somers et al. 1994a]
 
−
|1986-1991
 
−
|style="background-color:#1a9851"|Phase 3 (E-switch-ic)
 
−
|[[#CHVmP-VB|CHVmP-VB]]
 
−
| style="background-color:#1a9850" |Superior ORR
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1994.12.7.1366 Sertoli et al. 1994]
 
−
|1987-1991
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#MACOP-B|MACOP-B]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of OS36
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Methotrexate (MTX)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Mechlorethamine (Mustargen)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Procarbazine (Matulane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===References===
 
−
# Fisher RI, DeVita VT Jr, Hubbard SM, Longo DL, Wesley R, Chabner BA, Young RC. Diffuse aggressive lymphomas: increased survival after alternating flexible sequences of proMACE and MOPP chemotherapy. Ann Intern Med. 1983 Mar;98(3):304-9. [https://doi.org/10.7326/0003-4819-98-3-304 link to original article] [https://pubmed.ncbi.nlm.nih.gov/6600902 PubMed]
 
−
# Longo DL, DeVita VT Jr, Duffey PL, Wesley MN, Ihde DC, Hubbard SM, Gilliom M, Jaffe ES, Cossman J, Fisher RI, Young RC. 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. [https://doi.org/10.1200/jco.1991.9.1.25 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1702144 PubMed]
 
−
# Somers R, Carde P, Thomas J, Tirelli U, Keuning JJ, Bron D, Delmer A, de Bock R, De Wolf-Peeters C, van Glabbeke M, Duez N. EORTC study of non-Hodgkin's lymphoma: phase III study comparing CHVmP-VB and ProMACE-MOPP in patients with stage II, III, and IV intermediate- and high-grade lymphoma. Ann Oncol. 1994;5 Suppl 2:85-9. Erratum in: Ann Oncol 1994 May;5(5):475. [https://doi.org/10.1093/annonc/5.suppl_2.s85 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7515651 PubMed]
 
−
# Sertoli MR, Santini G, Chisesi T, Congiu AM, Rubagotti A, Contu A, Salvagno L, Coser P, Porcellini A, Vespignani M, Capnist G, Rossi E, Mangoni L, Fabris P, Vinante O, Tedeschi L, Endrizzi L, Miglio LP, Perrotta A, Rosso R, Damasio E, Rizzoli V. 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. [https://doi.org/10.1200/jco.1994.12.7.1366 link to original article] '''does not contain dosing details''' [https://pubmed.ncbi.nlm.nih.gov/7517442 PubMed]
 
−
==R-CHMP {{#subobject:5510fa|Regimen=1}}==
 
−
R-CHMP: '''<u>R</u>'''ituximab, '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>M</u>'''arqibo (Vincristine liposomal), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #1, 3 cycles {{#subobject:e77893|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1111/bjh.12446 Hagemeister et al. 2013]
 
−
|2001-2002
 
−
| style="background-color:#91cf61" |Phase 2
 
−
|-
 
−
|}
 
−
''This regimen was intended for stage I patients with no LN greater than 5 cm.''
 
−
====Targeted therapy====
 
−
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once on day 1
 
−
====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 liposomal (Marqibo)]] 2 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 3 cycles'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*[[#Radiation_therapy|RT]]
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #2, 6 cycles {{#subobject:a8501b|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1111/bjh.12446 Hagemeister et al. 2013]
 
−
|2001-2002
 
−
| style="background-color:#91cf61" |Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Targeted therapy====
 
−
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once on day 1
 
−
====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 liposomal (Marqibo)]] 2 mg/m<sup>2</sup> IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
'''21-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
#Hagemeister F, Rodriguez MA, Deitcher SR, Younes A, Fayad L, Goy A, Dang NH, Forman A, McLaughlin P, Medeiros LJ, Pro B, Romaguera J, Samaniego F, Silverman JA, Sarris A, Cabanillas F. Long term results of a phase 2 study of vincristine sulfate liposome injection (Marqibo(®) ) substituted for non-liposomal vincristine in cyclophosphamide, doxorubicin, vincristine, prednisone with or without rituximab for patients with untreated aggressive non-Hodgkin lymphomas. Br J Haematol. 2013 Sep;162(5):631-8. Epub 2013 Jun 27. [https://doi.org/10.1111/bjh.12446 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23802738 PubMed]
 
−
==VABE {{#subobject:583b52|Regimen=1}}==
 
−
VABE: '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>E</u>'''toposide, Prednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a1b549|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1991.9.5.741 O'Reilly et al. 1991]
 
−
|1983-1985
 
−
|style="background-color:#91cf61"|Non-randomized
 
−
|
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1991.9.5.741 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1707954 PubMed]
 
−
==VACOP-B {{#subobject:b78c96|Regimen=1}}==
 
−
VACOP-B: '''<u>V</u>'''epesid (Etoposide), '''<u>A</u>'''driamycin (Doxorubicin), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>B</u>'''leomycin
 
−
<br>P-VABEC: '''<u>P</u>'''rednisone, '''<u>V</u>'''incristine, '''<u>A</u>'''driamycin (Doxorubicin), '''<u>B</u>'''leomycin, '''<u>E</u>'''toposide, '''<u>C</u>'''yclophosphamide 
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:5b3956|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1093/oxfordjournals.annonc.a058295 Pichert et al. 1992]
 
−
|
 
−
|style="background-color:#ffffbe"|Retrospective
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1993.11.12.2362 Martelli et al. 1993]
 
−
|1988-1990
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===References===
 
−
# '''Retrospective:''' Pichert G, Peters J, Stahel RA, Dommann C, Joss R, Gebbers JO, Kroner T, Sulser H, Honegger HP, Maurer R, Pampallona S. 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. [https://doi.org/10.1093/oxfordjournals.annonc.a058295 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1280460 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. [https://doi.org/10.1200/jco.1993.11.12.2362 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7504091 PubMed]
 
−
==VCAP {{#subobject:31e6b7|Regimen=1}}==
 
−
VCAP: '''<u>V</u>'''indesine, '''<u>C</u>'''yclophosphamide,  '''<u>A</u>'''driamycin (Doxorubicin), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:0aaaf3|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[http://www.haematologica.org/content/90/6/802.long Bernard et al. 2005]
 
−
|1984-1996
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Vindesine (Eldisine)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===References===
 
−
# Bernard M, Cartron G, Rachieru P, LeMevel A, Branger B, Le Maignan C, Berthou C, Ghandour C, Delwail V, Milpied N, Cassasus P, Celigny PS, Guyotat D, Lamy T, Desablens B; GOELAMS. Long-term outcome of localized high-grade non-Hodgkin's lymphoma treated with high dose CHOP regimen and involved field radiotherapy: results of a GOELAMS study. Haematologica. 2005 Jun;90(6):802-9.  [http://www.haematologica.org/content/90/6/802.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/15951293 PubMed]
 
−
==VEPA {{#subobject:4ca994|Regimen=1}}==
 
−
VEPA: '''<u>V</u>'''incristine, '''<u>E</u>'''ndoxan (Cyclophosphamide), '''<u>P</u>'''rednisolone, '''<u>A</u>'''driamycin (Doxorubicin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:7285da|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.1988.6.1.128 Shimoyama et al. 1988 (JCOG8101)]
 
−
|1981-1983
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#VEPA-M_99|VEPA-M]]
 
−
| style="background-color:#ffffbf" |Did not meet efficacy endpoints
 
−
|-
 
−
|}
 
−
''Note: while the drugs are the same as those used in CHOP, administration details vary significantly; see paper for details.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Doxorubicin (Adriamycin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]]
 
−
</div></div>
 
−
===References===
 
−
# '''JCOG8101:''' Shimoyama M, Ota K, Kikuchi M, Yunoki K, Konda S, Takatsuki K, Ichimaru M, Ogawa M, Kimura I, Tominaga S, Tsugane S, Taguchi H, Minato K, Takenaka T, Tobinai K, Kurita S, Oyama A, Hisano S, Kozuru M, Matsumoto M, Nomura K, Takiguchi T, Sugai S, Yamaguchi K, Hattori T, Kinoshita K, Tajima K, Suemasu K. Chemotherapeutic results and prognostic factors of patients with advanced non-Hodgkin's lymphoma treated with VEPA or VEPA-M. J Clin Oncol. 1988 Jan;6(1):128-41. [https://doi.org/10.1200/JCO.1988.6.1.128 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2891797 PubMed]
 
−
==VNCOP-B {{#subobject:e53c96|Regimen=1}}==
 
−
VNCOP-B: '''<u>V</u>'''epesid (Etoposide), '''<u>N</u>'''ovantrone (Mitoxantrone), '''<u>C</u>'''yclophosphamide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone, '''<u>B</u>'''leomycin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:5b7296|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/89/11/3974.long Zinzani et al. 1997]
 
−
|1993-1995
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#VNCOP-B_.26_G-CSF_99|VNCOP-B & G-CSF]]
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of RFS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdf208 Zinzani et al. 2002]
 
−
|1996-2001
 
−
| style="background-color:#1a9851" |Phase 3 (C)
 
−
|[[#VNCOP-B_.26_G-CSF_99|VNCOP-B & G-CSF]] x 12 wk
 
−
| style="background-color:#ffffbf" |Did not meet endpoint of RFS60
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Mitoxantrone (Novantrone)]]
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Vincristine (Oncovin)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===References===
 
−
# Zinzani PL, Pavone E, Storti S, Moretti L, Fattori PP, Guardigni L, Falini B, Gobbi M, Gentilini P, Lauta VM, Bendandi M, Gherlinzoni F, Magagnoli M, Venturi S, Aitini E, Tabanelli M, Leone G, Liso V, Tura S. Randomized trial with or without granulocyte colony-stimulating factor as adjunct to induction VNCOP-B treatment of elderly high-grade non-Hodgkin's lymphoma. Blood. 1997 Jun 1;89(11):3974-9. [http://www.bloodjournal.org/content/89/11/3974.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/9166835 PubMed]
 
−
# Zinzani PL, Gherlinzoni F, Storti S, Zaccaria A, Pavone E, Moretti L, Gentilini P, Guardigni L, De Renzo A, Fattori PP, Falini B, Lauta VM, Mannina D, Zaja F, Mazza P, Volpe E, Lauria F, Aitini E, Ciccone F, Tani M, Stefoni V, Alinari L, Baccarani M, Tura S. Randomized trial of 8-week versus 12-week VNCOP-B plus G-CSF regimens as front-line treatment in elderly aggressive non-Hodgkin's lymphoma patients. Ann Oncol. 2002 Sep;13(9):1364-9. [https://doi.org/10.1093/annonc/mdf208 link to original article] [https://pubmed.ncbi.nlm.nih.gov/12196361 PubMed]
 
−
==VR-CHOP {{#subobject:477a16|Regimen=1}}==
 
−
VR-CHOP: '''<u>V</u>'''elcade (Bortezomib), '''<u>R</u>'''ituximab, '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne
 
−
<br>RB-CHOP: '''<u>R</u>'''ituximab, '''<u>B</u>'''ortezomib, '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''redniso(lo)ne
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:f22c05|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.2010.31.1142 Ruan et al. 2010 (Cornell 0309006313)]
 
−
|2004-2007
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1200/JCO.2017.73.2784 Leonard et al. 2017 (C05013)]
 
−
|2009-2013
 
−
|style="background-color:#1a9851"|Randomized Phase 2 (E-esc)
 
−
|[[Diffuse_large_B-cell_lymphoma#R-CHOP_.28Prednisolone.29|R-CHOP]]
 
−
|style="background-color:#ffffbf"|Did not meet primary endpoint of PFS
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Targeted therapy====
 
−
*[[Bortezomib (Velcade)]] 1.3 mg/m<sup>2</sup> IV once per day on days 1 & 4
 
−
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once on day 1
 
−
====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) IV once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 100 mg PO once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*'''Cornell 0309006313:''' "Standard" [[Acetaminophen (Tylenol)]] and [[Diphenhydramine (Benadryl)]] prior to [[Rituximab (Rituxan)]]
 
−
*'''C05013:''' Prophylaxis against VZV and PJP were recommended
 
−
'''21-day cycle for 6 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# '''Cornell 0309006313:''' Ruan J, Martin P, Furman RR, Lee SM, Cheung K, Vose JM, Lacasce A, Morrison J, Elstrom R, Ely S, Chadburn A, Cesarman E, Coleman M, Leonard JP. Bortezomib plus CHOP-rituximab for previously untreated diffuse large B-cell lymphoma and mantle cell lymphoma. J Clin Oncol. 2011 Feb 20;29(6):690-7. Epub 2010 Dec 28. [https://doi.org/10.1200/jco.2010.31.1142 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/21189393 PubMed] NCT00151320
 
−
# '''C05013:''' Leonard JP, Kolibaba KS, Reeves JA, Tulpule A, Flinn IW, Kolevska T, Robles R, Flowers CR, Collins R, DiBella NJ, Papish SW, Venugopal P, Horodner A, Tabatabai A, Hajdenberg J, Park J, Neuwirth R, Mulligan G, Suryanarayan K, Esseltine DL, de Vos S. Randomized phase II study of R-CHOP with or without bortezomib in previously untreated patients with non-germinal center B-cell-like diffuse large B-cell lymphoma. J Clin Oncol. 2017 Nov 1;35(31):3538-3546. Epub 2017 Sep 1. [https://doi.org/10.1200/JCO.2017.73.2784 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/28862883 PubMed] NCT00931918
 
−
# '''REMoDL-B:''' Davies A, Cummin TE, Barrans S, Maishman T, Mamot C, Novak U, Caddy J, Stanton L, Kazmi-Stokes S, McMillan A, Fields P, Pocock C, Collins GP, Stephens R, Cucco F, Clipson A, Sha C, Tooze R, Care MA, Griffiths G, Du MQ, Westhead DR, Burton C, Johnson PWM. Gene-expression profiling of bortezomib added to standard chemoimmunotherapy for diffuse large B-cell lymphoma (REMoDL-B): an open-label, randomised, phase 3 trial. Lancet Oncol. 2019 May;20(5):649-662. Epub 2019 Apr 1. [https://doi.org/10.1016/S1470-2045(18)30935-5 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6494978/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/30948276 PubMed] NCT01324596
 
−
=Consolidation after upfront therapy=
 
−
==Cyclophosphamide & TBI {{#subobject:0a4915|Regimen=1}}==
 
−
Cy/TBI: '''<u>Cy</u>'''clophosphamide & '''<u>T</u>'''otal '''<u>B</u>'''ody '''<u>I</u>'''rradiation
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:a2b2d3|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM198706113162402 Takvorian et al. 1987]
 
−
|1982-1987
 
−
| style="background-color:#91cf61" |Non-randomized
 
−
|-
 
−
|}
 
−
<section begin=a2b2d3 />
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]] 60 mg/kg IV once per day on days -3 & -2
 
−
====Radiotherapy====
 
−
*[[External_beam_radiotherapy|Total body irradiation (TBI)]]  1200 cGy in fractions on days –6 to –4 (pulmonary dosage was limited to 800 cGy)
 
−
</div>
 
−
<section end=a2b2d3 />
 
−
</div>
 
−
===References===
 
−
# Takvorian T, Canellos GP, Ritz J, Freedman AS, Anderson KC, Mauch P, Tarbell N, Coral F, Daley H, Yeap B, Schlossman SF, Nadler LM. Prolonged disease-free survival after autologous bone marrow transplantation in patients with non-Hodgkin's lymphoma with a poor prognosis. N Engl J Med. 1987 Jun 11;316(24):1499-505. [https://doi.org/10.1056/NEJM198706113162402 link to original article] [https://pubmed.ncbi.nlm.nih.gov/3295542 PubMed]
 
−
=Relapsed or refractory, salvage therapy=
 
−
==DHAP {{#subobject:cd4f8f|Regimen=1}}==
 
−
DHAP: '''<u>D</u>'''examethasone, '''<u>H</u>'''igh-dose '''<u>A</u>'''ra-C (Cytarabine), '''<u>P</u>'''latinol (Cisplatin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:ebcb68|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/71/1/117 Velasquez et al. 1988]
 
−
|1984-1986
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|[https://doi.org/10.1056/NEJM199512073332305 Philip et al. 1995 (PARMA)]
 
−
|1987-1994
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[#DHAP|DHAP]] x 2, then [[Transplant_conditioning_regimens#BEAC|BEAC]]
 
−
|style="background-color:#fc8d59"|Seems to have inferior OS
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdi248 Josting et al. 2005]
 
−
|NR
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|style="background-color:#d3d3d3"|
 
−
|style="background-color:#d3d3d3"|
 
−
|-
 
−
|}
 
−
''Note: Velasquez et al. 1988 report giving 6 to 10 courses, usually 4 courses beyond maximum response. To our knowledge, this regimen was not tested as an experimental arm in a RCT prior to becoming a standard comparator arm.''
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]] 40 mg IV over 15 minutes once per day on days 1 to 4
 
−
====Chemotherapy====
 
−
*[[Cytarabine (Ara-C)]] by the following age-based criteria:
 
−
**Patients younger than 70: 2000 mg/m<sup>2</sup> IV over 3 hours every 12 hours on day 2 (total dose per cycle: 4000 mg/m<sup>2</sup>)
 
−
**Patients older than 70: 1000 mg/m<sup>2</sup> IV over 3 hours every 12 hours on day 2 (total dose per cycle: 2000 mg/m<sup>2</sup>)
 
−
*[[Cisplatin (Platinol)]] 100 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on day 1
 
−
====Supportive therapy====
 
−
*[[Metoclopramide (Reglan)]] 1 mg/kg (route and frequency not indicated)
 
−
*[[Diphenhydramine (Benadryl)]] 25 mg IV (frequency not indicated)
 
−
'''3- to 4-week cycle for 2 cycles (PARMA & Josting et al. 2005) or up to 10 cycles (see note)'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*PARMA, responders (PR/CR) after cycle 2: [[#DHAP|DHAP]] x 4 versus [[Diffuse_large_B-cell_lymphoma#BEAC.2C_then_auto_HSCT|BEAC, then autologous HSCT]]
 
−
*Josting et al. 2005, responders (PR/CR) after cycle 2: [[#Methotrexate_monotherapy_88|HD-MTX with stem cell mobilization]], then [[Regimen_classes#High-dose_chemotherapy_with_auto_HSCT|HDT, then autologous HSCT]]
 
−
</div></div>
 
−
===References===
 
−
# Velasquez WS, Cabanillas F, Salvador P, McLaughlin P, Fridrik M, Tucker S, Jagannath S, Hagemeister FB, Redman JR, Swan F, Barlogie B. 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 dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/3334893 PubMed]
 
−
# '''PARMA:''' Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D, Sonneveld P, Gisselbrecht C, Cahn JY, Harousseau JL, Coiffier B, Biron P, Mandelli F, Chauvin F. 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. [https://doi.org/10.1056/NEJM199512073332305 link to original article] '''does not contain dosing details''' [https://pubmed.ncbi.nlm.nih.gov/7477169 PubMed]
 
−
# Josting A, Sieniawski M, Glossmann JP, Staak O, Nogova L, Peters N, Mapara M, Dörken B, Ko Y, Metzner B, Kisro J, Diehl V, Engert A. High-dose sequential chemotherapy followed by autologous stem cell transplantation in relapsed and refractory aggressive non-Hodgkin's lymphoma: results of a multicenter phase II study. Ann Oncol. 2005 Aug;16(8):1359-65. Epub 2005 Jun 6. [https://doi.org/10.1093/annonc/mdi248 link to original article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/15939712 PubMed]
 
−
==EPIC regimen {{#subobject:9f53f1|Regimen=1}}==
 
−
EPIC: '''<u>E</u>'''toposide, '''<u>P</u>'''rednisolone, '''<u>I</u>'''fosfamide,  '''<u>C</u>'''arboplatin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:c450a9|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1968387/ Hickish et al. 1993]
 
−
|1989-1991
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://doi.org/10.1002/hon.2900120304 Richardson et al. 1994]
 
−
|1991-1993
 
−
|style="background-color:#ffffbe"|Phase 2, <20 patients
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Ifosfamide (Ifex)]]
 
−
*[[Carboplatin (Paraplatin)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisolone (Millipred)]]
 
−
</div></div>
 
−
===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://doi.org/10.1038/bjc.1993.393 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1968387/ link to PMC article] [https://pubmed.ncbi.nlm.nih.gov/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://doi.org/10.1002/hon.2900120304 link to original article] [https://pubmed.ncbi.nlm.nih.gov/7959640 PubMed]
 
−
==HAM {{#subobject:c6c400|Regimen=1}}==
 
−
HAM: '''<u>H</u>'''igh-dose '''<u>A</u>'''ra-C (Cytarabine) & '''<u>M</u>'''itoxantrone
 
−
<br>NOAC: '''<u>NO</u>'''vantrone (Mitoxantrone) & '''<u>A</u>'''ra-'''<u>C</u>''' (Cytarabine)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:e86c0b|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1002/1097-0142%2819891001)64%3A7%3C1388%3A%3AAID-CNCR2820640703%3E3.0.CO%3B2-0 Ho et al. 1989]
 
−
|1986-1987
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cytarabine (Ara-C)]]
 
−
*[[Mitoxantrone (Novantrone)]]
 
−
</div></div>
 
−
===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://doi.org/10.1002/1097-0142%2819891001)64%3A7%3C1388%3A%3AAID-CNCR2820640703%3E3.0.CO%3B2-0 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2776103 PubMed]
 
−
==MINE {{#subobject:aff118|Regimen=1}}==
 
−
MINE: '''<u>M</u>'''esna, '''<u>I</u>'''fosfamide, '''<u>N</u>'''ovantrone (Mitoxantrone), '''<u>E</u>'''toposide
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:3a1597|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1995.13.7.1734 Rodriguez et al. 1995]
 
−
|NR
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Ifosfamide (Ifex)]] 1333 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 3
 
−
*[[Mitoxantrone (Novantrone)]] 8 mg/m<sup>2</sup> IV once on day 1
 
−
*[[Etoposide (Vepesid)]] 65 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 3
 
−
====Supportive therapy====
 
−
*[[Mesna (Mesnex)]] 1333 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 3
 
−
*[[Mesna (Mesnex)]] 500 mg PO once, diluted in water or juice, 4 hours following ifosfamide administration
 
−
'''21-day cycles (see below)'''
 
−
</div>
 
−
<div class="toccolours" style="background-color:#cbd5e7">
 
−
====Subsequent treatment====
 
−
*Rodriguez et al. 1995, CR: A total of 6 cycles of MINE, then [[#ESHAP|ESHAP]] consolidation x 3.
 
−
*Rodriguez et al. 1995, PR: MINE was given to the point of maximal response, and then patients were crossed over to ESHAP.
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1995.13.7.1734 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7602363 PubMed]
 
−
==VIM {{#subobject:d58124|Regimen=1}}==
 
−
VIM: '''<u>V</u>'''epesid (Etoposide), '''<u>I</u>'''fosfamide, '''<u>M</u>'''itoxantrone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:9817aa|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1111/j.1600-0609.1995.tb00261.x Hopfinger et al. 1995]
 
−
|1986-1992
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Ifosfamide (Ifex)]]
 
−
*[[Mitoxantrone (Novantrone)]]
 
−
</div></div>
 
−
===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://doi.org/10.1111/j.1600-0609.1995.tb00261.x link to original article] [https://pubmed.ncbi.nlm.nih.gov/7589338 PubMed]
 
−
==VIPD {{#subobject:bf2293|Regimen=1}}==
 
−
VIPD: '''<u>V</u>'''P-16 (Etoposide), '''<u>I</u>'''fosfamide,  '''<u>P</u>'''latinol (Cisplatin), '''<u>D</u>'''examethasone
 
−
<br>DVIP: '''<u>D</u>'''examethasone, '''<u>V</u>'''P-16 (Etoposide), '''<u>I</u>'''fosfamide,  '''<u>P</u>'''latinol (Cisplatin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:463c54|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1007/BF00686323 Haim et al. 1992]
 
−
|1989-1991
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]]
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Ifosfamide (Ifex)]]
 
−
*[[Cisplatin (Platinol)]]
 
−
</div></div>
 
−
===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://doi.org/10.1007/BF00686323 link to original article] [https://pubmed.ncbi.nlm.nih.gov/1628376 PubMed]
 
−
=Consolidation after salvage therapy=
 
−
==ESHAP {{#subobject:ff76de|Regimen=1}}==
 
−
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)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:562c75|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1995.13.7.1734 Rodriguez et al. 1995]
 
−
|NR
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#cbd5e8">
 
−
====Preceding treatment====
 
−
*[[#MINE|MINE]] salvage
 
−
</div>
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]] 60 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 4
 
−
*[[Cytarabine (Ara-C)]] 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 over 96 hours, started on day 1 (total dose per cycle: 100 mg/m<sup>2</sup>)
 
−
====Glucocorticoid therapy====
 
−
*[[Methylprednisolone (Solumedrol)]] 500 mg IV as a short infusion once per day on days 1 to 4
 
−
'''21-day cycle for 3 cycles'''
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1995.13.7.1734 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7602363 PubMed]
 
−
=Relapsed or refractory, further lines of therapy=
 
−
==CEPP(B) {{#subobject:bec105|Regimen=1}}==
 
−
CEPP(B): '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>P</u>'''rocarbazine, '''<u>P</u>'''rednisone, (optional) '''<u>B</u>'''leomycin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:696b13|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/76/7/1293.long Chao et al. 1990]
 
−
|1982-1989
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Procarbazine (Matulane)]]
 
−
*[[Bleomycin (Blenoxane)]]
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]]
 
−
</div></div>
 
−
===References===
 
−
# Chao NJ, Rosenberg SA, Horning SJ. CEPP(B): an effective and well-tolerated regimen in poor-risk, aggressive non-Hodgkin's lymphoma. Blood. 1990 Oct 1;76(7):1293-8. [http://www.bloodjournal.org/content/76/7/1293.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/2207307 PubMed]
 
−
==DICE {{#subobject:deaf96|Regimen=1}}==
 
−
DICE: '''<u>D</u>'''examethasone, '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>E</u>'''toposide
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:e35f1a|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/2.suppl_1.43 Goss et al. 1991]
 
−
|NR
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://pubmed.ncbi.nlm.nih.gov/11486401 Coleman et al. 2001]
 
−
|NR in abstract
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]]
 
−
====Chemotherapy====
 
−
*[[Ifosfamide (Ifex)]]
 
−
*[[Carboplatin (Paraplatin)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
</div></div>
 
−
===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://doi.org/10.1093/annonc/2.suppl_1.43 link to original article] [https://pubmed.ncbi.nlm.nih.gov/2043497 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. 2001 Jul;64:41-5. [https://pubmed.ncbi.nlm.nih.gov/11486401 PubMed]
 
−
==DICEP {{#subobject:9eab06|Regimen=1}}==
 
−
DICEP: '''<u>D</u>'''ose '''<u>I</u>'''ntensive '''<u>C</u>'''yclophosphamide, '''<u>E</u>'''toposide, '''<u>P</u>'''latinol (Cisplatin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:49a4cd|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.3109/07357909409021387 Neidhart et al. 1994]
 
−
|1987-1991
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Cyclophosphamide (Cytoxan)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
*[[Cisplatin (Platinol)]]
 
−
</div></div>
 
−
===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://doi.org/10.3109/07357909409021387 link to original article] [https://pubmed.ncbi.nlm.nih.gov/8281458 PubMed]
 
−
==EPOCH {{#subobject:eca645|Regimen=1}}==
 
−
EPOCH: '''<u>E</u>'''toposide, '''<u>P</u>'''rednisone, '''<u>O</u>'''ncovin (Vincristine), '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin)
 
−
<br>CHEOP: '''<u>C</u>'''yclophosphamide, '''<u>H</u>'''ydroxydaunorubicin (Doxorubicin), '''<u>E</u>'''toposide, '''<u>O</u>'''ncovin (Vincristine), '''<u>P</u>'''rednisone
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:492bdc|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 80%; text-align:center;"
 
−
!style="width: 25%"|Study
 
−
!style="width: 25%"|Years of enrollment
 
−
!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 25%"|[[Levels_of_Evidence#Efficacy|Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1993.11.8.1573 Wilson et al. 1993]
 
−
|1990-1992
 
−
|style="background-color:#91cf61"|Phase 2
 
−
| style="background-color:#e0ecf4" |ORR: 87%
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]] 50 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1 (total dose per cycle: 200 mg/m<sup>2</sup>)
 
−
*[[Vincristine (Oncovin)]] 0.4 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1 (total dose per cycle: 1.6 mg/m<sup>2</sup>)
 
−
*[[Cyclophosphamide (Cytoxan)]] 750 mg/m<sup>2</sup> IV over 15 minutes once on day 6
 
−
*[[Doxorubicin (Adriamycin)]] 10 mg/m<sup>2</sup>/day IV continuous infusion over 96 hours, started on day 1 (total dose per cycle: 40 mg/m<sup>2</sup>)
 
−
====Glucocorticoid therapy====
 
−
*[[Prednisone (Sterapred)]] 60 mg/m<sup>2</sup> PO on days 1 to 6
 
−
====Supportive therapy====
 
−
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, starting on day 6 and continuing until ANC >5000/uL past nadir
 
−
*PCP prophylaxis with any one of the following:
 
−
**[[Trimethoprim-Sulfamethoxazole (Bactrim DS)]] 160/800 mg PO twice per day 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'''
 
−
</div></div>
 
−
===References===
 
−
# Wilson WH, Bryant G, Bates S, Fojo A, Wittes RE, Steinberg SM, Kohler DR, Jaffe ES, Herdt J, Cheson BD, Chabner BA. EPOCH chemotherapy: toxicity and efficacy in relapsed and refractory non-Hodgkin's lymphoma. J Clin Oncol. 1993 Aug;11(8):1573-82 [https://doi.org/10.1200/jco.1993.11.8.1573 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/7687667 PubMed]
 
−
## '''Update:''' Gutierrez M, Chabner BA, Pearson D, Steinberg SM, Jaffe ES, Cheson BD, Fojo A, Wilson WH. Role of a doxorubicin-containing regimen in relapsed and resistant lymphomas: an 8-year follow-up study of EPOCH. J Clin Oncol. 2000 Nov 1;18(21):3633-42. [https://doi.org/10.1200/JCO.2000.18.21.3633 link to original article] [https://pubmed.ncbi.nlm.nih.gov/11054436 PubMed]
 
−
==ESHAP {{#subobject:4c0082|Regimen=1}}==
 
−
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)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:ae8823|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1994.12.6.1169 Velasquez et al. 1994]
 
−
|1986-1988
 
−
|style="background-color:#1a9851"|Phase 3 (E-esc)
 
−
|[[#ESHA_88|ESHA]]
 
−
|style="background-color:#1a9850"|Superior RR
 
−
|-
 
−
|[https://doi.org/10.3816/CLML.2010.n.017 Avilés et al. 2010]
 
−
|NR
 
−
|style="background-color:#1a9851"|Phase 3 (C)
 
−
|[[Diffuse_large_B-cell_lymphoma#R-ESHAP|R-ESHAP]]
 
−
|style="background-color:#ffffbf"|Did not meet efficacy endpoints
 
−
|-
 
−
|}
 
−
''Note: timing of cycle was variable and dependent on "recovery of the toxic effects"
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Etoposide (Vepesid)]] 40 mg/m<sup>2</sup> IV over 60 minutes once per day on days 1 to 4
 
−
*[[Cytarabine (Ara-C)]] 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 over 96 hours, started on day 1 (total dose per cycle: 100 mg/m<sup>2</sup>)
 
−
====Glucocorticoid therapy====
 
−
*[[Methylprednisolone (Solumedrol)]] 250 to 500 mg IV over 15 minutes once per day on days 1 to 5
 
−
====Supportive therapy====
 
−
*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 (route not specified) "given regularly"
 
−
'''21- to 28-day cycle for 6 to 8 cycles'''
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1994.12.6.1169 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.3816/CLML.2010.n.017 link to original article] [https://pubmed.ncbi.nlm.nih.gov/20371445 PubMed]
 
−
==Etoposide, Ifosfamide, Methotrexate {{#subobject:d49400|Regimen=1}}==
 
−
IMVP-16: '''<u>I</u>'''fosfamide, '''<u>M</u>'''ethotrexate, '''<u>VP-16</u>''' (Etoposide)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:9f78e9|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[http://www.bloodjournal.org/content/60/3/693.long Cabanillas et al. 1982]
 
−
|NR
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Ifosfamide (Ifex)]]
 
−
*[[Methotrexate (MTX)]]
 
−
*[[Etoposide (Vepesid)]]
 
−
</div></div>
 
−
===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. [http://www.bloodjournal.org/content/60/3/693.long link to original article] [https://pubmed.ncbi.nlm.nih.gov/7104493 PubMed]
 
−
==GDP {{#subobject:20e899|Regimen=1}}==
 
−
GDP: '''<u>G</u>'''emcitabine, '''<u>D</u>'''examethasone, '''<u>P</u>'''latinol (Cisplatin)
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:325d38|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1002/cncr.20587 Crump et al. 2004]
 
−
|2001-2002
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Chemotherapy====
 
−
*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 & 8
 
−
*[[Cisplatin (Platinol)]] 75 mg/m<sup>2</sup> IV over 60 minutes once on day 1
 
−
====Glucocorticoid therapy====
 
−
*[[Dexamethasone (Decadron)]] 40 mg IV or PO once per day on days 1 to 4
 
−
'''21-day cycle for up to 6 cycles'''
 
−
</div></div>
 
−
===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; National Cancer Institute of Canada Clinical Trials Group. 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. [https://doi.org/10.1002/cncr.20587 link to original article] [https://pubmed.ncbi.nlm.nih.gov/15386331 PubMed]
 
−
==ICE {{#subobject:f535c2|Regimen=1}}==
 
−
ICE: '''<u>I</u>'''fosfamide, '''<u>C</u>'''arboplatin, '''<u>E</u>'''toposide
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #1, inpatient {{#subobject:d573d9|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1200/jco.1999.17.12.3776 Moskowitz et al. 1999]
 
−
|1993-1997
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdg702 Zelenetz et al. 2003]
 
−
|1993-2000
 
−
|style="background-color:#91cf61"|Phase 2
 
−
|-
 
−
|}
 
−
''Third cycle intended to be followed by peripheral blood hematopoietic cell collection''
 
−
====Chemotherapy====
 
−
*[[Ifosfamide (Ifex)]] 5000 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on day 2, '''mixed with mesna'''
 
−
*[[Carboplatin (Paraplatin)]] AUC 5 (maximum dose of 800 mg) 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
 
−
====Supportive therapy====
 
−
*[[Mesna (Mesnex)]] 5000 mg/m<sup>2</sup> IV continuous infusion over 24 hours, started on day 2, '''mixed with [[Ifosfamide (Ifex)]]'''
 
−
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day on days 5 to 12 (10 mcg/kg with cycle 3, given until collection of peripheral blood hematopoietic cells)
 
−
'''14-day cycle for 3 cycles; treatment can be delayed until ANC is greater than 1000/uL and platelet count greater than 50 x 10<sup>9</sup>/L'''
 
−
</div></div><br>
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen variant #2, outpatient {{#subobject:b30a1b|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 60%; text-align:center;"
 
−
!style="width: 33%"|Study
 
−
!style="width: 33%"|Years of enrollment
 
−
!style="width: 33%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
|-
 
−
|[https://doi.org/10.1093/annonc/mdg703 Hertzberg et al. 2003]
 
−
|NR
 
−
| style="background-color:#ffffbe" |Phase 2, <20 pts in this subgroup
 
−
|-
 
−
|}
 
−
''Third cycle intended to be followed by peripheral blood hematopoietic cell collection''
 
−
====Chemotherapy====
 
−
*[[Ifosfamide (Ifex)]] 1667 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3, '''mixed with mesna'''
 
−
*[[Carboplatin (Paraplatin)]] AUC 5 (maximum dose of 800 mg) IV over 60 minutes once on day 1
 
−
*[[Etoposide (Vepesid)]] 100 mg/m<sup>2</sup> IV over 30 minutes once per day on days 1 to 3
 
−
====Supportive therapy====
 
−
*[[Mesna (Mesnex)]] 1667 mg/m<sup>2</sup> IV over 2 hours once per day on days 1 to 3, '''mixed with [[Ifosfamide (Ifex)]]'''
 
−
*[[Filgrastim (Neupogen)]] 5 mcg/kg SC once per day, started on day 5
 
−
'''21-day cycle for 3 cycles'''
 
−
</div></div>
 
−
===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. [https://doi.org/10.1200/jco.1999.17.12.3776 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1093/annonc/mdg702 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/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. [https://doi.org/10.1093/annonc/mdg703 link to original article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/12736225 PubMed]
 
−
==R-INO {{#subobject:429f9a|Regimen=1}}==
 
−
R-INO: '''<u>R</u>'''ituximab, '''<u>INO</u>'''tuzumab ozogamicin
 
−
<div class="toccolours" style="background-color:#eeeeee">
 
−
===Regimen {{#subobject:9a3b4b|Variant=1}}===
 
−
{| class="wikitable sortable" style="width: 100%; text-align:center;"
 
−
!style="width: 20%"|Study
 
−
!style="width: 20%"|Years of enrollment
 
−
!style="width: 20%"|[[Levels_of_Evidence#Evidence|Evidence]]
 
−
!style="width: 20%"|Comparator
 
−
!style="width: 20%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
−
|-
 
−
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878046/ Fayad et al. 2013 (B1931004)]
 
−
|2006-NR
 
−
|style="background-color:#91cf61"|Phase 1/2
 
−
| style="background-color:#d3d3d3" |
 
−
| style="background-color:#d3d3d3" |
 
−
|-
 
−
|[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200343/ Dang et al. 2017 (B1931008)]
 
−
|2011-2013
 
−
| style="background-color:#1a9851" |Phase 3 (E-switch-ooc)
 
−
|Investigator's choice of:<br>1a. [[Diffuse_large_B-cell_lymphoma#Bendamustine_.26_Rituximab_.28BR.29_2|BR]]<br>1b. [[Diffuse_large_B-cell_lymphoma#Gemcitabine_.26_Rituximab|Gemcitabine & Rituximab]]
 
−
| style="background-color:#ffffbf" |Did not meet primary endpoint of OS<br>Median OS: 9.5 vs 9.5 mo<br>(HR 1.1, 95% CI 0.8-1.4)
 
−
|-
 
−
|}
 
−
<div class="toccolours" style="background-color:#b3e2cd">
 
−
====Targeted therapy====
 
−
*[[Rituximab (Rituxan)]] 375 mg/m<sup>2</sup> IV once on day 1
 
−
====Antibody-drug conjugate therapy====
 
−
*[[Inotuzumab ozogamicin (Besponsa)]] 1.8 mg/m<sup>2</sup> IV once on day 2
 
−
'''28-day cycle for up to 8 cycles'''
 
−
</div></div>
 
−
===References===
 
−
# '''B1931004:''' Fayad L, Offner F, Smith MR, Verhoef G, Johnson P, Kaufman JL, Rohatiner A, Advani A, Foran J, Hess G, Coiffier B, Czuczman M, Giné E, Durrant S, Kneissl M, Luu KT, Hua SY, Boni J, Vandendries E, Dang NH. Safety and clinical activity of a combination therapy comprising two antibody-based targeting agents for the treatment of non-Hodgkin lymphoma: results of a phase I/II study evaluating the immunoconjugate inotuzumab ozogamicin with rituximab. J Clin Oncol. 2013 Feb 10;31(5):573-83. Epub 2013 Jan 7. [https://doi.org/10.1200/jco.2012.42.7211 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878046/ link to PMC article] '''contains dosing details in manuscript''' [https://pubmed.ncbi.nlm.nih.gov/23295790 PubMed] NCT00299494
 
−
# '''B1931008:''' Dang NH, Ogura M, Castaigne S, Fayad LE, Jerkeman M, Radford J, Pezzutto A, Bondarenko I, Stewart DA, Shnaidman M, Sullivan S, Vandendries E, Tobinai K, Ramchandren R, Hamlin PA, Giné E, Ando K. Randomized, phase 3 trial of inotuzumab ozogamicin plus rituximab versus chemotherapy plus rituximab for relapsed/refractory aggressive B-cell non-Hodgkin lymphoma. Br J Haematol. 2018 Aug;182(4):583-586. Epub 2017 Jul 5. [https://doi.org/10.1111/bjh.14820 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6200343/ link to PMC article] '''contains dosing details in abstract''' [https://pubmed.ncbi.nlm.nih.gov/28677896 PubMed] NCT01232556
 
−
[[Category:Diffuse large B-cell lymphoma regimens]]
 
−
[[Category:Historical regimens]]
 
−
[[Category:Disease-specific pages]]
 
−
[[Category:Aggressive lymphomas]]
 
−
[[Category:Non-Hodgkin lymphomas]]
 

Latest revision as of 00:13, 18 June 2023

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