CHOP vs MEV for the treatment of non-Hodgkin's lymphoma of unfavourable histopathology: a randomized clinical trial.

The Swedish Lymphoma Study Group has compared the results of treatment with a CHOP regimen (cyclophosphamide, adriamycin, vincristine and prednisone) with those of treatment with a MEV regimen (methotrexate, cyclophosphamide and vincristine) in patients suffering from generalized non-Hodgkin's lymphoma (NHL) of unfavourable histopathology in a prospective randomized trial. The complete remission rate for 67 evaluable patients receiving CHOP was higher (61%) than for 74 patients receiving MEV (24%) (P less than 0.001). The relapse rate was 18/41 (44%) in the CHOP group and 11/18 (61%) in the MEV group (difference not significant). At follow-up the number of patients alive in a first complete remission was thus 23/67 in the CHOP group but only 7/74 (9%) in the MEV group. This difference is highly significant (P less than 0.001). However, there is still no significant difference in overall survival between the two treatment groups. This is probably due to the more efficient rescue treatment (mainly CHOP) found in the patients who primarily received MEV than in those who primarily received CHOP. It is concluded that the CHOP regimen is superior to the MEV regimen in NHL patients with unfavourable histopathology.

RCT Entities:   Population Interventions Outcomes