MACOP-B Chemotherapy for the Treatment of Diffuse Large-Cell Lymphoma

TLDR

MACOP‑B is a 12‑week weekly chemotherapy regimen for advanced diffuse large‑cell lymphoma that combines methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, bleomycin, antibiotic prophylaxis, and daily corticosteroids. In 61 patients, MACOP‑B achieved an 84 % complete response rate, 76 % overall survival at a median 23‑month follow‑up, 90 % relapse‑free survival among complete responders, and modest toxicity (one treatment‑related death, seven serious infections, mucositis most frequent), demonstrating it is an effective 12‑week regimen comparable or superior to longer protocols.

Abstract

Between April 1981 and May 1984, 61 patients with advanced diffuse large-cell lymphoma completed treatment with MACOP-B (methotrexate with leucovorin rescue, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin), an innovative pilot chemotherapy program emphasizing weekly treatment, antibiotic prophylaxis, daily corticosteroid treatments, and brief duration (12 weeks). Fifty-one patients (84%) achieved a complete response and 10 patients (16%) had a partial response. Over a median follow-up after treatment of 23 months, the actuarial overall survival for the entire group has been 76%; for complete responders the relapse-free survival has been 90%. Toxicity was modest with one treatment-related death and seven episodes of serious infection. The most frequent toxicity was mucositis. Thus, MACOP-B is an effective treatment for large-cell lymphoma that can be delivered in 12 weeks with an acceptable incidence of toxicity. This regimen can achieve results similar and possibly superior to those of other presently used regimens of longer duration.