ABCVEP (I) treatment for advanced intermediate grade and high grade non-Hodgkin's lymphoma
Yasushi KuraishiNoriko UsuiTadashi KobayashiT. NakamuraH YamazakiHidekuni KaitoT UnosawaAmami KatoHiroyoshi MiharaShingo YanoYukihide IsogaiK Takagi
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Regimen
Prednisolone
Procarbazine
Forty consecutive patients with small cell bronchogenic carcinoma were treated. The first 18 patients were treated with CCNU and doxorubicin (Adriamycin) (CA). The next 22 patients were treated with CCNU, doxorubicin, procarbazine, and vincristine (CAPO). Patient characteristics were similar. The partial plus complete response rate was 55% (ten of 18 patients) in the CA group compared to 41% (nine of 22 patients) in the CAPO group. The median survival from treatment was 28 weeks in the CA group compared to 33 weeks in the CAPO group. There were no drug-related deaths among the patients receiving CA compared to two definite and three probably drug-related deaths among the patients receiving CAPO. The addition of procarbazine and vincristine to CA for the treatment of small cell bronchogenic carcinoma resulted in increased toxicity and no survival benefit.
Procarbazine
Lomustine
Bronchogenic carcinoma
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Thirty-nine untreated patients with either lymphocytic or nodular mixed/nodular histiocytic non-Hodgkin's lymphoma, stage II-IV, were randomized to treatment with total body irradiation (TBI), 100 rads in 10 fractions over 12 days, plus combination chemotherapy with either cyclophosphamide, vincristine and prednisone (CVP) or cyclophosphamide, vincristine, procarbazine and prednisone (C-MOPP) or to treatment with combination chemotherapy (CVP or C-MOPP) alone. Remission rate and duration were comparable for both treatment groups; thus the use of both treatment modalities ab initio provides no therapeutic advantage.
Procarbazine
Combination chemotherapy
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This study evaluates the use of a combination of 4 drugs—nitrogen mustard, vincristine, procarbazine, and prednisone—in 15 patients with generalized lymphosarcoma (LSA) and 8 patients with reticulum cell sarcoma (RCS). Of the 15 patients with LSA, there were 7 complete remissions (CR) and 5 partial remissions (PR). Among the 8 RCS patients, 3 achieved CR and 2 achieved PR. The mean duration of unmaintained complete remission calculated from therapy completion was 11.7+ mos. (0–25+) for LSA patients and 32+ mos. (23–37+) for RCS patients. Mean survival from the onset of therapy was 30.6+ mos. (18–45+) for the LSA patients achieving CR with 5 of 7 patients still surviving and 2 patients still free of disease. For RCS patients, survival was 30+, 42+, and 42+ mos. for the 3 patients achieving CR, with all 3 still free of disease. Moderate myelosuppression was produced. This combination of agents produces remissions of substantial duration in patients with LSA and RCS.
Procarbazine
Reticulum Cell Sarcoma
Nitrogen mustard
Combination chemotherapy
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Procarbazine
Nitrogen mustard
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Thirty-nine untreated patients with either lymphocytic or nodular mixed/nodular histiocytic non-Hodgkin's lymphoma, stage II--IV, were randomized to treatment with total body irradiation (TBI), 100 rads in 10 fractions over 12 days, plus combination chemotherapy with either cyclophosphamide, vincristine and prednisone (CVP) or cyclophosphamide, vincristine, procarbazine and prednisone (C-MOPP) or to treatment with combination chemotherapy (CVP or C-MOPP) alone. Remission rate and duration was comparable for both treatment groups; thus the use of both treatment modalities ab initio provides no therapeutic advantage.
Procarbazine
Combination chemotherapy
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This study was designed to test the efficacy and toxicity of COP (cyclophosphamide, vincristine, and prednisone) and MOPP (nitrogen mustard, vincristine, prednisone, and procarbazine) in 13 previously untreated patients with disseminated, nodular, poorly differentiated, lymphocytic lymphoma, and to test for patient cross-resistance to the regimens. Complete remission was initially achieved in six of eight patients on COP and three of five on MOPP. Three patients were crossed over to the alternative induction regimen because of progressive disease after an initial partial response; one was crossed over because of toxicity. On crossover, four patients achieved complete remission, two on either regimen. Durations of unmaintained complete remission range from 6—46+ months, with 8/13 still in their first complete remission. Only one patient has died, while in remission, from progressive Kaposi's sarcoma; one was lost to follow-up while in complete remission at 44 months; the others (85%) remain alive 33–54 months from the initiation of chemotherapy. MOPP was significantly more toxic with respect to thrombocytopenia, duration of myelosuppression, and cumulation of toxicity. Because of its more acceptable toxicity, COP is recommended as initial therapy for patients with nodular, poorly differentiated, lymphocytic lymphoma. MOPP or another regimen of non-crossresistant combination chemotherapy would be more appropriate for primary treatment failures.
Procarbazine
Nitrogen mustard
Regimen
Combination chemotherapy
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Procarbazine
Lomustine
Combination chemotherapy
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2 cases of recurrent medulloblastomas are described who both responded to vincristine alone and in combination with procarbazine. The combination of vincristine and procarbazine is discussed and recommended for chemotherapy of medulloblastomas. The effectiveness of adjuvant chemotherapy after the primary treatment should be investigated.
Procarbazine
Adjuvant Chemotherapy
Combination chemotherapy
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While procarbazine with 1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea (PC) added to vincristine (PCV) was proven beneficial in the treatment of co-deleted anaplastic oligodendroglioma (AO), the question of whether PC alone is sufficient is important, as vincristine adds toxicity with uncertain benefit. This retrospective study provides a comparison of PC and PCV.Patients diagnosed with AO treated at the M.D. Anderson Cancer Center from June 1, 1993 to October 13, 2009 were selected from the database and were eligible if diagnosed with a primary AO and treated with either PC or PCV at some point. Ninety-seven patients were treated with such chemotherapy before first progression.Initial treatment included radiation and chemotherapy (81.4%) or chemotherapy alone (18.6%). Twenty-one patients (21.6%) received PC during primary treatment, while 76 patients (78.4%) received PCV. Eleven patients reported neurotoxicity in the PCV arm vs. none in the PC arm. Out of the 97 patients, 45 were alive at last contact, with a median follow-up of 9.9 years. The median overall survival was 6.5 years (95% confidence interval=4.8-16.7 years), while the median progression-free survival was 2.9 years (95% confidence interval=2.0-6.3 years); these differences were not significant (p=0.61 and p=0.28, respectively).Initial therapy with PC achieved comparable results to those of PCV with a median follow-up of 9.9 years. Neurotoxicity was more frequent with vincristine. Although selecting only for patients with AO, rather than those with mixed histology, increased the likelihood of selecting for patients with tumors with co-deletions, further studies with correlative co-deletion status are required.
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Lomustine
Dacarbazine
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To compare the progression-free survival of dogs with high-grade T-cell lymphoma treated with either a cyclophosphamide, doxorubicin, vincristine and prednisone-based or a modified mechlorethamine, vincristine, prednisone and procarbazine chemotherapy protocol.In this retrospective study, cases were selected based on histologic or cytologic diagnosis of lymphoma, T-cell phenotype, hypercalcaemia, or both, and no previous chemotherapy for lymphoma. Treatment was not randomly allocated.Seventy-three dogs were included in this study: 50 in the cyclophosphamide, doxorubicin, vincristine and prednisone group and 23 in the mechlorethamine, vincristine, prednisone and procarbazine group. The median progression-free survival was 133 days for dogs in the cyclophosphamide, doxorubicin, vincristine and prednisone group and 97 days for dogs in the mechlorethamine, vincristine, prednisone and procarbazine group. When golden retrievers (n = 16) were evaluated -separately, progression-free survival was longer in the cyclophosphamide, doxorubicin, vincristine and prednisone versus mechlorethamine, vincristine, prednisone and procarbazine treatment group (median PFS 154 days versus 70.5 days, respectively).The progression-free survival time for dogs with multi-centric T-cell lymphoma treated with a modified mechlorethamine, vincristine, prednisone and procarbazine protocol was similar to that of dogs treated with cyclophosphamide, doxorubicin, vincristine and prednisone. Further studies, including those evaluating golden retrievers separately, are needed to confirm these findings.
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