Abstract
Interferon alfa has been found to be effective as an antitumor agent (with a response rate of 30 percent) in patients with low-grade non-Hodgkin's lymphoma, but its effectiveness in those with intermediate-grade non-Hodgkin's lymphoma has been less adequately tested. In a prospective randomized study we evaluated the effectiveness of adding interferon alfa to cytotoxic chemotherapy in patients with clinically aggressive, low-grade non-Hodgkin's lymphoma and certain histologic variants of intermediate-grade non-Hodgkin's lymphoma, not including diffuse histiocytic lymphoma. The patients were randomly assigned to a regimen of cyclophosphamide, vincristine, prednisone, and doxorubicin or to this regimen combined with recombinant interferon alfa. Treatment was administered every four weeks, for 8 to 10 cycles. The two regimens produced comparable objective responses, but the regimen including interferon had a greater effect in prolonging the time to treatment failure (P<0.001) and the duration of complete response (P = 0.03). Interferon alfa also had a greater effect on overall survival (P = 0.014) when the results were adjusted for important covariates. Interferon alfa, when added to a four-drug doxorubicin-based chemotherapy regimen, is an effective antitumor agent in patients with clinically aggressive low-grade or intermediate-grade non-Hodgkin's lymphoma. (N Engl J Med 1992;327:1336–41.), INTERFERON ALFA has been found to be an effective therapeutic agent in patients with low-grade non-Hodgkin's lymphoma. Early studies using both crude natural and recombinant forms of this interferon demonstrated an effective antitumor response rate of 33 percent to 50 percent in patients with this relatively indolent lymphoma.1 2 3 4 5 6 7 8 9 10 11 12 Patients with intermediate-grade non-Hodgkin's lymphoma tended to have fewer objective responses,1 2 3 4 , 6 7 8 except in one study of a larger number of patients with intermediate-grade non-Hodgkin's lymphoma13; that study reported a response rate comparable to the rate in patients with low-grade non-Hodgkin's lymphoma.13 On the basis of these single-agent studies, pilot trials have… © 1992, Massachusetts Medical Society. All rights reserved.