Between November 1990 and April 1995, 36 patients with intermediate to high grade non Hodgkin's lymphoma were treated with a COP-BLAM V (cyclophosphamide, vincristine, prednisone, bleomycin, adriamycin, procarbazine) combination chemotherapy, 1 patient was unevaluable due to lost follow-up. The median age was 51(range 23~71) 21 patients were male and 14 patients were female. The most common histologic type was diffuse large cell type(51.4%) and others were diffuse small cleaved cell type(22.8%), diffuse mixed cell type(20.0%), follicular large cell type(2.9%) and small noncleaved cell type(2.9%). Among 35 evaluated patients 13 patients (37.1%) had B symptoms. The stage II, III, IV was 77.1%, 8.6%, 14.3% respectively. The extranodal involvement was existed as follows, gastrointestinal tract(20%), Waldeyer's ring (11.4%), liver, spleen(5.7%), Bone marrow(5.7%), and skin, pleura, nasal septum(2.9% each). Complete remission(CR) rate was 88.6%, and overall response rate was 97.2%. The range of relapse free survival was from 1 to 36 months. The median relapse free survival was not reached due to short follow period. The range of actuarial survival duration was from 3 to 36 months. Actuarial 2 year survivial rate was 59.4% and acturial median survival duration was 28 months(the median follow up time: 18 months). There was no statistical signigicance af 2 year survival rate between early CR group(achieve CR less than 3 cycles of combination chemotherapy) and late CR group(62.3% vs 55.2% p=0.0958). Patient who had gastrointestinal tract involvement had lower CR rate(p=0.019), patients achieving CR (p<0.05), and non involving gastrointestinal tract(p(0.005) had higher 2 year survival rate. The main hematologic toxicities were leukopenia(45.2% ) and anemia(33.5%). Non-hematologic side effects were GI symptoms-nausea/vomiting(80.0%), hepatic toxicity(2.9%), alopecia (100%), mucositis(51.4%) and pulmonary toxicity(8.6%). Based on high complete remission rate and tolerable toxicity, COP-BLAM V seems to be an effective treatment regimen for the intermediate and high grade non-Hodgkin's lymphoma. In order to reduce treatment related toxicity, we must consider prognostic factors and do tailored therapy to the patients according to prognostic factors.
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