Between 1979 and 1985 61 consecutive patients with non-Hodgkin's lymphomas of unfavourable histology (mostly diffuse large cell lymphomas subclassified according to Kiel nomenclature) were treated in our departments by either the CHOP- (n = 34) or the COPBLAM-regimen (n = 27). A retrospective analysis revealed that prognostic variables, excluding primary central nervous system (CNS)-involvement (n = 5), were equally distributed between both groups. Remission rates were significantly higher in the COPBLAM treated patients as compared with the CHOP treated group (85 per cent versus 38 per cent CR, P = 0.001) even when cases with primary CNS-disease were excluded. The survival curve did not reach a plateau in CHOP treated cases, whereas 85 per cent of the COPBLAM treated group reached a plateau by 15 months. The mean observation time, however, was shorter in the COPBLAM treated group (37 versus 30 months, respectively). It is concluded that the COPBLAM regimen is superior to the CHOP-protocol in inducing complete responses in aggressive non-Hodgkin's lymphomas. Longer follow-ups are needed to definitely show if this corresponds to an increased proportion of 'cures'.

Adolescent↗

PubMedDate not supplied

Efficacy and safety of immunoglobulin apheresis.

Extracorporeal procedures such as plasmapheresis or protein a apheresis have been applied successfully to remove autoantibodies in the treatment of severe forms of various autoimmune diseases. A newly developed immunoapheresis technique that uses columns containing polyclonal anti human immunoglobulin (Ig) antibodies was investigated in four patients with idiopathic thrombocytopenic purpura (ITP). A series of two to four treatments were performed, and the period between the two series was dependent on the actual thrombocyte count. A total of 38 treatments was carried out. During the first apheresis, IgG declined to a mean of 52.7% of the initial concentration. The IgG subclasses one through four were decreased to the same extent. The IgA was lowered to 64.4%, and IgM was lowered to 66.7%. A series of four aphereses yielded a 75-80% decline of the different Ig species. A further decrease in Ig would have been possible, but was not aimed at in this study. All Ig fractions reincreased between the two series. In two patients, a rise in thrombocytes as a response to treatment was observed. Apart from three hypotensive reactions and one episode of hypocalcemia, no further side effects occurred in 38 treatments. The authors conclude that Ig apheresis with anti human Ig antibodies is an effective and safe form of treatment. Its effect on the clinical course of autoimmune diseases merits further investigation.

Adolescent↗