Lymphoma Clinical Trial
Official title:
Randomised Controlled Trial of CID (Chlorambucil, Idarubicin, Dexamethasone) Versus CD (Chlorambucil, Dexamethasone) for Induction of Remission in Low Grade Non-Hodgkin's Lymphoma (Kiel Classification) Followed by Randomised Controlled Assessment of Standard Dose Interferon Versus Low Dose Interferon Versus No Further Therapy as Maintenance Treatment After Remission Induction
RATIONALE: Drugs used in chemotherapy use different ways to stop cancer cells from dividing
so they stop growing or die. Interferon alfa may interfere with the growth of cancer cells
and slow the growth of non-Hodgkin's lymphoma. It is not yet known whether combining more
than one chemotherapy drug with interferon alfa is more effective than chemotherapy alone in
treating patients with low-grade non-Hodgkin's lymphoma.
PURPOSE: Randomized phase III trial to compare the effectiveness of combination chemotherapy
with or without interferon alfa in treating patients with low-grade non-Hodgkin's lymphoma.
OBJECTIVES: I. Compare the remission induction rates and toxicity of chlorambucil plus
dexamethasone with or without idarubicin in patients with stage II-IV low grade
non-Hodgkin's lymphoma. II. Assess the additional value of a period of
consolidation/maintenance treatment utilizing low dose interferon alfa or standard dose
interferon alfa versus no further treatment in relationship to the duration of event-free
survival in these patients.
OUTLINE: This is a randomized, open label, controlled, multicenter study. Patients are
randomized into one of two arms for induction chemotherapy. Arm I: Patients receive oral
chlorambucil three times daily for 3 consecutive days, oral idarubicin daily for 3
consecutive days, and oral dexamethasone twice daily for 5 consecutive days every 21 days.
Arm II: Patients receive oral chlorambucil three times daily for 3 consecutive days and oral
dexamethasone twice daily for 5 consecutive days every 21 days. Treatment for both arms
continues for up to 6 courses in the absence of disease progression or unacceptable
toxicity. After 6 courses of chemotherapy, patients are reassessed. If they have achieved
maximal complete response or good partial response, patients are randomized into one of
three arms. Arm I: Patients receive no further treatment until disease progresses. Arm II:
Patients receive low dose interferon alfa subcutaneously three times per week for a maximum
of 3 years in the absence of disease progression. Arm III: Patients receive standard dose
interferon alfa subcutaneously three times a week for a maximum of 3 years in the absence of
disease progression. Patients are followed every 8-12 weeks for 3 years.
PROJECTED ACCRUAL: There will be 200 patients accrued into this study with approximately 150
patients entering the second phase of this study.
;
Allocation: Randomized, Primary Purpose: Treatment
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