The COP-BLAM programs: evolving chemotherapy concepts in large cell lymphoma.

M. Coleman, J. O. Armitage, M. Gaynor, D. McDermott, D. D. Weisenburger, K. Adler, M. Beshevkin, R. T. Silver, A. M. Reisman, M. W. Pasmantier

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43 Scopus citations

Abstract

The cyclophosphamide, vincristine, prednisone, bleomycin, doxorubicin, procarbazine (COP-BLAM) programs of combination chemotherapy were administered to patients with advanced diffuse large cell lymphoma. The original COP-BLAM programs were designed to deliver intense multidrug therapy maximizing tumor kill. COP-BLAM programs IA and IB, easily administered on an outpatient basis, produced identical 73% complete remissions (CRs) and 55% long-term, disease-free survival (DFS). COP-BLAM III, an outgrowth of studies using infusional therapy, differed from COP-BLAM by using infusional bleomycin and vincristine alternated with bolus vincristine. With COP-BLAM III, 84% CRs, 76% "potential cures," and a 65% DFS were produced at a median follow-up time of 50 months. COD-BLAM IV, using four sequential cycles of infusional chemotherapy, high-dose alternating myelosuppressives (doxorubicin, cyclophosphamide), and cycle-active agents (methotrexate, cytarabine, and etoposide) produced 88% CRs, 67% potential cures, and a 64% DFS at a median follow-up of 24 months. COP-BLAM V employs four to six sequential cycles of infusional chemotherapy tailored to the rapidity of response. Preliminary results in patients with high-risk Hodgkin's disease suggest COP-BLAM V may be effective despite the shortened treatment time. In all programs, prognostic factors were critical determinants in the results achieved, particularly age and rapidity of response.

Original languageEnglish (US)
Pages (from-to)23-33
Number of pages11
JournalSeminars in hematology
Volume25
Issue number2 Suppl 2
StatePublished - Apr 1988

ASJC Scopus subject areas

  • Hematology

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    Coleman, M., Armitage, J. O., Gaynor, M., McDermott, D., Weisenburger, D. D., Adler, K., Beshevkin, M., Silver, R. T., Reisman, A. M., & Pasmantier, M. W. (1988). The COP-BLAM programs: evolving chemotherapy concepts in large cell lymphoma. Seminars in hematology, 25(2 Suppl 2), 23-33.