Standard chemotherapy with interferon compared with CHOP followed by high-dose therapy with autologous stem cell transplantation in untreated patients with advanced follicular lymphoma: the GELF-94 randomized study from the Groupe d'Etude des Lymphomes de l'Adulte (GELA)

Sebban, Catherine;Mounier, Nicolas;Brousse, Nicole;Belanger, Coralie;Coiffier, Bertrand;et.al.
(2006) Blood — Vol. 108, n° 8, p. 2540-2544 (2006)

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  • Sebban, Catherine
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  • Mounier, Nicolas
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  • Brousse, Nicole
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  • Belanger, Coralie
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  • Doyen, Chantalorcid-logoUCLouvain
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  • Coiffier, Bertrand
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Abstract
The purpose of this study is to compare our standard chemotherapy regimen (CHVP [cyclophosphamide, doxorubicin, teniposide, and prednisone]) plus interferon with 4 courses of CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) followed by high-dose therapy with autologous stem cell transplantation (ASCT) in treatment-naive patients with advanced follicular lymphoma. Four hundred one patients were included from July 1994 to March 2001: 209 received 12 cycles of CHVP plus interferon c, for 18 months (CHVP-I arm) and 192 received 4 cycles of CHOP followed by high-dose therapy (HDT) with total body irradiation and ASCT (CHOP-HDT arm). Overall response rates were similar in both groups (79% and 78% after induction chemotherapy, respectively). One hundred thirty-one of the 150 patients eligible for HOT underwent transplantation (87%). Intent-to-treat analysis after a median follow-up of 7.5 years showed that there was no difference between the 2 arms for overall survival (P = .53) or event-free survival (P = .11). Patients with a complete response at the end of the induction therapy had a statistically longer event-free survival and overall survival (P = .02 and <.001, respectively). After long-term follow-up, our study showed that there was no statistically significant benefit in favor of first-line high-dose therapy in patients with follicular lymphoma. High-dose therapy should be reserved for relapsing patients.
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Sebban, C., Mounier, N., Brousse, N., Belanger, C., Brice, P., Haioun, C., Tilly, H., Feugier, P., Bouabdallah, R., Doyen, C., Salles, G., & Coiffier, B. (2006). Standard chemotherapy with interferon compared with CHOP followed by high-dose therapy with autologous stem cell transplantation in untreated patients with advanced follicular lymphoma: the GELF-94 randomized study from the Groupe d’Etude des Lymphomes de l’Adulte (GELA). Blood, 108(8), 2540-2544. https://doi.org/10.1182/blood-2006-03-013193 (Original work published 2006)