Abstract:
Objective To evaluate the safety and therapeutic efficacy of a new treatment method for adult acute lymphoblastic leukemia (ALL) and non-Hodgkin's lymphoma (NHL) patients in China. The treatment was a modified regimen of hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone (hyper-CVAD) alternated with high-dose methotrexate and cytarabine (MA).
Methods A retrospective analysis was done for 17 ALL and 8 NHL patients treated with the modified hyper-CVAD/MA regimen in the First Affiliated Hospital of Anhui Medical University between May 2006 to June 2011. The relevant safety and efficacy of the treatment regimen were evaluated.
Results All 25 patients underwent 40 cycles of the hyper-CVAD regimen and 29 cycles of the MA regimen. The one-year overall survival (OS) rate of the patients reached 61.3% ± 10.2% after the treatments. The one-year OS rate of the 17 adult ALL patients was 62.6% ± 12.2%. Compared with the patients who only received one cycle of the hyper-CVAD/MA regimen, those who underwent two to 4 cycles of the regimen achieved a longer OS rate (P=0.046). The one-year OS rate of the 8 NHL patients was 60.0% ± 18.2%. Compared with the patients who only received two cycles of the regimen, those who received 4 to 7 cycles of the treatment attained a longer OS rate (P=0.021). The major untoward reaction included myelosuppression and infection. However, these toxic side effects were within acceptable limits. Delaying the B cycle could not reduce these side effects.
Conclusion The modified hyper-CVAD/MA regimen has a satisfactory therapeutic effect on patients with lymphoid malignancies, and the side effects of the regimen are controllable.