First-line R-CVP vs R-CHOP Induction Immunochemotherapy for Indolent Lymphoma and R Maintenance.

Inclusion Criteria:

• Histologically confirmed:

• Follicular lymphoma grade 1, 2, 3a

• Marginal zone lymphoma, including MALT type

• Small lymphocytic lymphoma (BM inv. < 30%)

• Lymphoplasmacytic lymphoma

• Clinical stage II-IV (Ann Arbor). Stage I is allowed if bulky (Ø > 7 cm) or ifradiotherapy is not appropriate in judgment of treating physician

• Measurable lesion(s) in at least one site

• Patients previously untreated

• Patients presenting with symptoms requiring treatment:

• Progressive disease

• Symptoms related to tumor bulk

• Cytopenias related to bone marrow and/or spleen involvement B symptoms

• Age ≥ 18 years

• Performance status </=2

• Written informed consent

Exclusion Criteria:

• Grade 3b FL

• Transformed lymphoma

• CNS involvement

• Patient taking steroids for > 2 weeks during last 4 weeks at a dose equivalent to ≥ 20mg prednisone

• Other malignancy

• Major surgery within 4 weeks

• Hb < 8 g/dl, ANC < 1.5 x 109/L, Plt <100 109/L unless due to lymphoma

• Impairment of renal function (creatinine > 1.5 x UNV) or liver function (totalbilirubin 1.5 x UNV, SGOT > 2.5 x UNV not due to lymphoma

• Known infection, with HBV, HCV (acute < 6 mos. or chronic hepatitis) or HIV

• Serious underlying medical conditions

• Life expectancy < 6 months

• Known allergy to murine protein