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According to an article recently published in Leukemia and Lymphoma, the treatment combination referred to as CHOP-GR (cyclophosphamide, doxorubicin, vincristine, prednisone, rituximab, and G-CSF) appeared effective in the treatment of advanced-stage follicular lymphoma.

Non-Hodgkin’s lymphoma (NHL) is a form of cancer that begins in the cells of the lymph system. The lymph system includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. The main cells in the lymph system are lymphocytes, of which there are two types: B- and T-cells. Each cell type has a specific function in helping the body fight infection.

NHL is characterized by the excessive accumulation of atypical (cancerous) lymphocytes. These lymphocytes can crowd the lymph system and suppress the formation and function of other immune and blood cells. NHL is categorized by the type of lymphocyte it involves and by the rate at which the cancer grows.

Follicular lymphoma is considered to be a low-grade or indolent lymphoma, which means that it is a slow-growing subset of NHL. Advanced follicular NHL is considered incurable with standard treatment approaches.

CHOP plus Rituxan® (rituximab) is a standard therapy for advanced follicular NHL. Rituxan is an agent that is targeted against specific immune cells that tend to be cancerous in NHL. Neupogen® (G-CSF) is an agent that stimulates the production and maturation of specific immune cells. Researchers speculate that Neupogen may boost the effects of Rituxan against cancerous immune cells.

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Researchers from Japan recently conducted a clinical trial to evaluate CHOP-GR in the treatment of advanced follicular NHL. This trial included 21 patients who had not received prior treatment for their disease.

  • Anticancer responses occurred in 76% of patients.
  • At two years progression-free survival was 82%.
  • At two years overall survival was 95%.
  • The most frequent side effects were low levels of certain immune cells. This occurred in 100% of patients.

The researchers concluded that CHOP-GR is a safe and effective treatment regimen for advanced follicular NHL. Future trials are necessary to directly compare CHOP plus Rituxan to CHOP-GR to truly determine the effectiveness of adding Neupogen to this regimen.

Reference: Tomita N, Kodama F, Oshima R, et al. Phase II Study of CHOP-GR Therapy for Advanced-Stage Follicular Lymphoma. Leukemia and Lymphoma. 2006;47:1041-1047.

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