What is the role of the CHOP regimen in the treatment of lymphoblastic lymphoma?

Updated: Sep 10, 2019
  • Author: Joseph M Tuscano, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Answer

In children with lymphoblastic lymphoma, chemotherapy regimens similar to treatments for acute lymphoblastic leukemia (ALL) have produced 5-year disease-free survival rates ranging from 60% to 80%. ALL regimens may be equally effective in adults, although many adults are treated with regimens traditionally designed for diffuse intermediate-grade lymphoma (which were predominantly diffuse large B-cell lymphoma in the new World Health Organization [WHO] classification), such as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like regimens. Depending on the regimen, response rates in adults ranged from 55% to 95%, with leukemia-type regimens producing rates greater than70%.

A randomized trial in children compared the LSA2 -L2 leukemia regimen with a more traditional CHOP-like regimen (COMP; M = additional methotrexate) and found the LSA2 -L2 regimen superior in terms of response and overall survival rates. Subsequently, a number of studies have used chemotherapy/radiotherapy LSA2 -L2 –like regimens in adults with lymphoblastic lymphoma. Most are characterized by the standard leukemialike sequence of intensive remission induction, central nervous system (CNS) prophylaxis, consolidation, and prolonged maintenance. Most of these studies produced long-term disease-free survival rates of 40-60% in adults.


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