Combination versus successive single agent chemotherapy in lymphocytic lymphoma

Fifty‐three patients with advanced lymphocytic lymphoma were randomly assigned to treatment with the combination cyclophosphamide, vincristine, and prednisone (CVP) or the same agents used successively in maximal doses (C‐V‐P). Complete remissions occurred in 68% with CVP and 48% with C‐V‐P. For patients with nodular lymphoma, the complete remission rate was 81% with CVP and 46% with C‐V‐P. In patients with diffuse lymphoma a complete remission rate of 50% was obtained with both regimens. The median duration of response was longer for patients who obtained complete remission with CVP (37+ months) than for those entering remission with C‐V‐P (25+ months). More patients treated with CVP still survive. Current results suggest that CVP is a better induction regime than C‐V‐P in patients with nodular lymphoma. However, in patients with diffuse lymphocytic lymphoma, neither regimen results in more than 50% complete remissions or significant numbers of prolonged responses. More effective therapy is needed.