6703 Background: To confirm the efficacy and safety of standard CHOP therapy in Japanese pts with L or L-I risk aggressive NHL, we conducted a multicenter phase II study with overall survival (OS) as primary endpoint. Methods: Eligibility criteria were as follows: newly-diagnosed, intermediate or high grade NHL by Working Formulation; L or L-I risk by International Prognostic Index (IPI); clinical stage of II, III, IV or bulky I; ages less than 70; PS 0–3. Eight courses of standard CHOP therapy were given every 3 weeks. Involved-field radiotherapy (30 to 40 Gy) was added after chemotherapy for bulky disease at baseline, and was optional for residual tumors. Results: Between June 1995 and May 1999, a total of 213 pts were enrolled, and 173 pts were pathologically eligible (diffuse large B; 68%) by the central review according to WHO classification. Out of 173 pts, 87 and 80 pts were of L and L-I risk, respectively. Three pts with high-intermediate IPI risk, 1 high IPI risk, 1 stage I without bulky disease, and 1 prior radiotherapy were ineligible. % complete response of L and L-I risk pts was 83% (95% CI; 74–90%) and 74% (95% CI; 63–83%), respectively. Five-year OS was 73% (95% CI; 64–83%) and 64% (95% CI; 53–74%), and 5-year progression-free survival (PFS) was 63% (95% CI; 52–73%) and 38% (95% CI; 27–59%). Major toxicity by JCOG toxicity criteria in all treated pts (212 pts) was grade 4 neutropenia (64%). Non-hematologic toxicities were acceptable; the most frequent grade 3 toxicity was nausea/vomiting (3%), and grade 4 toxicity was observed in one who developed paralytic ileus. One treatment-related death was observed due to hepatitis B virus reactivation. Conclusions: CHOP was confirmed to be a standard therapy in Japanese pts with L or L-I risk aggressive NHL. However, the relatively low %PFS suggests the necessity of further investigations to find more effective first-line therapy for L-I risk pts. No significant financial relationships to disclose.