CNOP for diffuse aggressive non-Hodgkin's lymphoma: The Nebraska Lymphoma Study Group experience

Julie M. Vose, Dennis D. Weisenburger, James C. Lynch, Philip J. Bierman, John C. Chan, Martin Bast, Patricia Aoun, Gregory Bociek, Timothy Greiner, James O. Armitage, Charles Enke, John Okerbloom, Julie Vose, Robert Warne, William Schleuter, Sitki Copur, David Howe, Craig Nichols, George Bascom, Cynthia LewisMark Hutchins, Daniel Moravec, Alan Berg, Cary Peterson, Scott Sorensen, Susan Hansen, Patrick Judson, Lana Scott-Timperly, Robert Langdon, Margaret Block, Peter Townley, Stephen Lemon, David Silverberg, Gamini Soori, Herbert Hartman, Douglas Jones, Vincent Bjorling, William Packard, David Garfield, Jeffery Matous, Robert Rifkin, Robert Berris, Nicholas DiBella, Kyle Fink

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The purpose of this study was to evaluate the CNOP regimen (cyclophosphamide, mitoxantrone, vincristine, and prednisone) throughout a community based oncology network with a large number of elderly non-Hodgkin's lymphoma (NHL) patients. Three hundred and seventy-three previously untreated patients with diffuse aggressive NHL received the CNOP regimen administered through a community oncology network, the Nebraska Lymphoma Study Group (NLSG). The complete response rate was 60% with an overall response rate of 73%. The estimated 4-year event-free survival for patients <60 years was 44%, compared to 38% for those >age 60 (p = 0.18). However, the 4-year estimated overall survival for patients <60 years was 62% compared to 44% for those >60 years (p < 0.001). Prognostic factors predictive for a poor event-free survival were male gender, stage III/IV disease, Karnofsky score <80, and elevated lactic dehydrogenase (LDH). The lymphoma specific cumulative death rate was 29% for patients <60 years compared with 33% for patients >60 years (p = 0.07). After failing CNOP the 4-year overall survival (OS) was 19%. The estimated 4-year OS for patients who failed CNOP and went on to receive high-dose chemotherapy (HDC) and autologous hematopoietic stem cell transplant (ASCT) was 64% for patients <age 60 and 48% for those >60 years (p = 0.23). In conclusion, CNOP chemotherapy administered to patients with diffuse aggressive NHL in a community oncology network produces similar result to that reported for other anthracycline based regimens reported in the literature. Patients >age 60 had a higher rate of failure due to causes other than lymphoma which accounted for a worse survival long-term. However, patients of all ages who failed CNOP and who were able to receive HDC and ASCT demonstrated long-term disease survival after the transplant.

Original languageEnglish (US)
Pages (from-to)799-804
Number of pages6
JournalLeukemia and Lymphoma
Issue number4
StatePublished - 2002

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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