Evolving Recommendations

The guidelines will need to be reviewed regularly and updated as treatment regimens change and/or new drugs are introduced. For example, cyclosphosphamide, doxorubicin, vincristine, prednisone (CHOP)-14 has been proposed as a new standard regime for patients older than 60 yr with aggressive NHL (10). In this study, CHOP administration was intensified (a 14-d cycle vs a 21-d cycle) in the two-weekly regime with rHuG-CSF starting from d 4. This administration provided improved results compared with standard CHOP 21; no improvement was achieved by the addition of etoposide, in part owing to its toxicity in this population.

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