Accelerated R-COP:A Pilot Study for the Treatment of Follicular Lymphoma.

To test the hypothesis that dose intensity/dose density treatment may improve the complete response rate and remission duration in patients with follicular lymphoma (grades I and II, ECOG performance 0–2, Stages III and IV, progressive disease), a combination of known effective agents were administered as follows: rituximab,375 mg/m2; cyclophosphamide, 1000 mg/m2; and vincristine, 2mg (cap), IV every two weeks. Prednisone, 50 mg, was given p.o., every other day for 30 days then tapered over the next 30 days. G- CSF was administered days 7–10 following each treatment. Patients were evaluated for response after 5 and 10 cycles, that included imaging with CT and PET scans. Toxicity was mild to moderate, consisting mainly of paresthesias, requiring attenuation of the vincristine dose in some patients. There were no instances of neutropenic fever requiring hospitalization. In this pilot study, 6 of 7 patients previously untreated achieved a CR, and none have relapsed to date (6+ to 20+ months after completion of treatment). Two heavily treated patients, including relapse from agents used in this regimen, had PRs, lasting 2 and 8+ months. This program is well tolerated with a high CR rate, and may serve as a basis for future trials.