{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T01:38:32Z","timestamp":1770428312840,"version":"3.49.0"},"reference-count":31,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"24","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2002,12,15]]},"abstract":"<jats:p> PURPOSE: To compare in a phase III study the safety and efficacy of fludarabine to that of cyclophosphamide, vincristine, and prednisone (CVP) in recurrent, low-grade, non-Hodgkin\u2019s lymphoma after previous response to systemic treatment. <\/jats:p><jats:p> PATIENTS AND METHODS: Patients were randomized to fludarabine (25 mg\/m<jats:sup>2<\/jats:sup> intravenously on days 1 to 5, every 28 days) or CVP (cyclophosphamide 750 mg\/m<jats:sup>2<\/jats:sup> and vincristine 1.2 mg\/m<jats:sup>2<\/jats:sup> both intravenously on day 1 and prednisone 40 mg\/m<jats:sup>2<\/jats:sup> orally on days 1 to 5, every 21 days). The primary outcome assessed was progression-free survival (PFS); secondary outcomes included treatment-free survival (TFS), overall survival (OS), treatment-related toxicity, and quality of life (QoL) according to the European Organization for Research and Treatment of Cancer\u2019s Quality of Life Questionnaire C-30 version 1.0 instrument. <\/jats:p><jats:p> RESULTS: Ninety-one patients were randomized, 47 to fludarabine and 44 to CVP. There was no difference in response rates, with 64% (complete response [CR], 9%) for fludarabine versus 52% (CR, 7%) for CVP (P = .72). With a median follow-up of 42 months, median PFS (11 months v 9.1 months; P = .03) and TFS (15 months v 11 months; P = .02) were superior in patients receiving fludarabine. No difference in median overall survival was detected (57 months for fludarabine v 44 months for CVP; P = .95). Three patients receiving fludarabine died of treatment-related toxicity compared with none of the patients receiving CVP. Peripheral neuropathy and alopecia were more common with CVP. Patients receiving fludarabine had higher scores for social function (P = .008); no other differences in QoL were detected. <\/jats:p><jats:p> CONCLUSION: In recurrent low-grade lymphoma, fludarabine improves PFS, TFS, and social function scores in comparison with CVP but does not improve OS. <\/jats:p>","DOI":"10.1200\/jco.2002.11.068","type":"journal-article","created":{"date-parts":[[2002,12,17]],"date-time":"2002-12-17T22:39:33Z","timestamp":1040164773000},"page":"4649-4654","source":"Crossref","is-referenced-by-count":53,"title":["Randomized Phase III Study of Fludarabine Phosphate Versus Cyclophosphamide, Vincristine, and Prednisone in Patients With Recurrent Low-Grade Non-Hodgkin\u2019s Lymphoma Previously Treated With an Alkylating Agent or Alkylator-Containing Regimen"],"prefix":"10.1200","volume":"20","author":[{"given":"Richard J.","family":"Klasa","sequence":"first","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph M.","family":"Meyer","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chaim","family":"Shustik","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carol A.","family":"Sawka","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Smith","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Gu\u00e9vin","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Maksymiuk","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morel","family":"Rubinger","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Samosh","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne","family":"Laplante","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; Hamilton Regional Cancer Center, Hamilton, London Regional Cancer Centre, London, and St Catherine\u2019s Clinic, St Catherine\u2019s, Ontario; McGill Oncology Group, Hopital Saint-Luc, and Berlex Canada, Montreal, Quebec; Toronto-Sunnybrook Regional Cancer Centre, Toronto; Saskatoon Cancer Centre, Saskatoon, Saskatchewan; and Cancercare Manitoba, Winnipeg, Manitoba, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean-Fran\u00e7ois","family":"Grenier","sequence":"additional","affiliation":[{"name":"From the Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, British Columbia; 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