Best treatment of aggressive non-Hodgkin's lymphoma: a French perspective

Abstract

The Groupe d'Etude des Lymphomes de l'Adulte (GELA) has conducted several phase II and III studies in patients with aggressive lymphoma, diffuse large B-cell lymphoma (DLBCL), and T-cell lymphomas during the past 20 years, in France and Belgium. These studies, have demonstrated that the outcome of patients with DLBCL may be improved and that the standard CHOP (cyclophosphamide, doxorubicin HCl, vincristine [Oncovin], prednisone) regimen is not sufficient to cure a large number of patients. The first improvement was the demonstration of superiority of a dose-dense and dose-intense regimen, ACVBP (doxorubicin [Adriamycin], cyclophosphamide, vindesine, bleomycin, prednisone). The second improvement was made in young patients with poor-risk lymphoma by intensifying their treatment with high-dose therapy and autotransplant. The third and most significant improvement was in the results associated with the combination of rituximab (Rituxan) and chemotherapy. Current studies look at decreasing the. number of patients truly refractory to chemotherapy, decreasing relapse rate with rituximab maintenance, and finding an appropriate regimen for patients with T-cell lymphoma.