OBSERVATION VS. INTENSIVE CHEMOTHERAPY FOR INDOLENT LYMPHOMA

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This study was designed ten years ago to compare the efficacy and the long- term survival of two very different therapeutic approaches towards previously untreated patients with indolent lymphoma: observation or delayed therapy (watch and wait) vs. initial intensive combination chemotherapy with ProMACE/MOPP flexitherapy to complete remission, followed by consolidative modified total nodal irradiation. To date there are no significant differences in disease-free survival or overall survival, although there are differences in complete response rates between the two randomized groups with 75% of patients randomized to intensive therapy achieving a complete response compared to a CR rate of 29% in those treated after a period of observation. The median follow-up time is six years, shorter than the median survival (10 years) of patients with these diagnoses. Continued follow-up may show a benefit for a subset of patients.