Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outcomes
Outline
Trial Contact Information
Registry Information

Alternate Title

Combination Chemotherapy in Treating Patients With Newly Diagnosed Stage III or Stage IV Non-Hodgkin's Lymphoma

Basic Trial Information

Phase	Type	Status	Age	Sponsor	Protocol IDs
Phase III	Treatment	Closed	18 to 70	Other	BNLI-MCD/FMD EU-20035, NCT00006250

Objectives

1. Compare the overall survival rate, progression free survival rate, clinical and molecular remission rates, and time to treatment failure in patients with newly diagnosed stage III or IV follicular non-Hodgkin's lymphoma treated with chlorambucil, mitoxantrone, and dexamethasone versus fludarabine, mitoxantrone, and dexamethasone.
2. Compare the efficacy and tolerability of these regimens in these patients.

Entry Criteria

Disease Characteristics:

• Histologically proven newly diagnosed stage III or IV follicular non-Hodgkin's lymphoma
  • REAL classification grade I, II, or III



• Treatment necessity indicated by presence of the following:
  • B symptoms
  • Bone marrow failure
  • Bulky or progressive disease
  • Compression syndromes



• No CNS involvement

Prior/Concurrent Therapy:

Biologic therapy:

• Not specified

Chemotherapy:

• Not specified

Endocrine therapy:

• No concurrent systemic corticosteroids

Radiotherapy:

• Not specified

Surgery:

• Not specified

Other:

• No prior therapy

Patient Characteristics:

Age:

• 18 to 70

Performance status:

• Not specified

Life expectancy:

• Not specified

Hematopoietic:

• No autoimmune hemolytic anemia or active hemolysis
• Direct Coombs' negative

Hepatic:

• Alkaline phosphatase no greater than 2.5 times upper limit of normal (ULN)*
• Bilirubin no greater than 2.5 times ULN*

 [Note: *Unless attributable to lymphoma]

Renal:

• Creatinine no greater than 2.5 times ULN (unless attributable to lymphoma)

Cardiovascular:

• No severe cardiac failure
• Ejection fraction at least 45%

Other:

• Not pregnant or nursing
• Fertile patients must use effective contraception during and for at least 6 months after study
• HIV negative
• No prior malignancy except carcinoma in situ of the cervix or squamous cell skin cancer
• No other serious medical disease that would limit lifespan or ability to tolerate chemotherapy

Expected Enrollment

A total of 500 patients (250 per arm) will be accrued for this study within 4 years.

Outcomes

Time to treatment failure
Progression-free survival rate
Overall survival rate

Clinical remission rate
Molecular remission rate

Outline

This is a randomized, multicenter study. Patients are stratified according to International Prognostic Index score [low risk (score 1) vs intermediate low risk (score 2) vs intermediate high risk (score 3) vs high risk (score 4 or 5)]. Patients are randomized to one of two treatment arms.

• Arm I: Patients receive mitoxantrone IV on day 1, oral chlorambucil on days 1-10, and oral dexamethasone on days 1-5.



• Arm II: Patients receive mitoxantrone and dexamethasone as in arm I and fludarabine IV on days 1-3.

Treatment continues every 4 weeks for 4-8 courses.

Patients are followed at 3, 6, and 12 months, every 6 months for 1 year, and then annually thereafter until clinical relapse.

Trial Contact Information

Trial Lead Organizations

Lymphoma Trials Office

Andy Haynes, MD, Protocol chair		Ph: 0115-9691169 ext. 46704 Email: andy.haynes@nottingham.ac.uk

Registry Information
Official Title		Randomized Trial of MCD Versus FMD in Untreated Advanced Follicular Lymphoma
Trial Start Date		2000-05-31
Registered in ClinicalTrials.gov		NCT00006250
Date Submitted to PDQ		2000-07-14
Information Last Verified		2007-03-26

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