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Indian Journal of Medical and Paediatric Oncology
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Year : 2003  |  Volume : 24  |  Issue : 3  |  Page : 5-8

Ifosfamide based intensive mcp-842 protocol in diffuse intermediate and High-grade non-Hodgkin's lymphoma

Division of Medical Oncology, Cancer Institute (WIA), Chennai, India

Correspondence Address:
TG Sagar
Division of Medical Oncology, Cancer Institute (WIA), Chennai, India

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Source of Support: None, Conflict of Interest: None

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Background: CHOP (Cyclophosphamide, Vincristine, adriamycin and prednisolone) is the standard chemotherapy for intermediate and high grade none Hodgkin's lymphoma (NHL). We evaluated a new third generation combination chemotherapy protocol 'MCP 842' for the treatment of patients with advanced NHL. Patients and methods: 110 patients with aggressive diffuse NHL of intermediate and high grade (Working formulation) were treated with 'MCP 842' between December, 1985 and December, 1993. The protocol was designed in collaboration with the paediatric branch of National Cancer Institute, Bethesda, Maryland, USA. This protocol contains 7 drug comprising myelosuppressive and non or less myelosuppressive drugs administered alternately. Results: Patients median age was 35 years, male to female ratio being 2.79 :1 Ann Arbor staging revealed-stage I-10 percent, II-31 percent, III-39 percent and stage IV in 20 percent of patients. 36.4 percent of patients had B symptoms. 52 percent of patients had high grade and 48 percent had intermediate grade histology as per working formulation. Following chemotherapy 66.4 percent of patients achieved CR. Response rate was significantly higher in patients with early stage (stage I-II vs III-IV; 80 percent vs 57 percent, p.08), absence of `B' symptoms (78 percent vs 45 percent p.001) and in those with absence of bulky abdominal lymph nodes (p.001). Kaplan Meier probability of event-free and disease-free survival at 5 years was 48.3 percent and 69.5 percent, respectively. Marrow toxicity was the predominant toxicity and there were three infection related deaths. Concussions: In our hands, results of this new third generation protocol were not superior to those reported with standard CHOP.

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