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R-COMP 21 for frail elderly patients with aggressive B-cell non-Hodgkin lymphoma: a pilot study.

Abstract
We evaluated the toxicity and efficacy of nonpegylated liposomal doxorubicin (Myocet) when substituted for conventional doxorubicin in the CHOP-21 regimen in the treatment of frail elderly patients with aggressive non-Hodgkin lymphoma. Twenty frail patients (median age, 73 years), as defined by Balducci et al., with diffuse large B cell or grade IIIb follicular lymphoma, either at diagnosis (15 patients) or relapsed (five patients), were prospectively enrolled. Nine out of 20 (45%) had a World Health Organisation (WHO) performance status > or =2. Fifteen out of 20 patients (75%) had an International Prognostic Index (IPI) score > or =3. Thirteen out of 20 (65%) evaluable patients obtained a complete response. Five additional patients (25%) achieved a partial response. With a median follow-up of 24 months (range 18-27), 15/18 responding patients (83%) are alive and disease free, as well as 3/18 are alive with active disease. Toxicity was mainly hematological with grade 3/4 neutropenia in 26% of cycles and febrile neutropenia in 5%. However, 3/20 patients presented a grade III-IV WHO toxicity (one fatal pulmonary embolism, one congestive, and one ischemic heart failure) while receiving R-COMP chemotherapy. In conclusion, R-COMP-21 is an effective regimen with promising response rates for frail and elderly patients with aggressive non-Hodgkin lymphoma.
AuthorsGiuseppe Visani, Felicetto Ferrara, Francesco Alesiani, Sonia Ronconi, Massimo Catarini, Francesca D'adamo, Barbara Guiducci, Daniele Bernardi, Sara Barulli, Pierpaolo Piccaluga, Marco Rocchi, Alessandro Isidori
JournalLeukemia & lymphoma (Leuk Lymphoma) Vol. 49 Issue 6 Pg. 1081-6 (Jun 2008) ISSN: 1029-2403 [Electronic] United States
PMID18569635 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone
Topics
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal (administration & dosage)
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Cyclophosphamide (administration & dosage)
  • Doxorubicin (administration & dosage)
  • Female
  • Frail Elderly
  • Humans
  • Lymphoma, Follicular (drug therapy)
  • Lymphoma, Large B-Cell, Diffuse (drug therapy)
  • Male
  • Maximum Tolerated Dose
  • Middle Aged
  • Pilot Projects
  • Prednisone (administration & dosage)
  • Prognosis
  • Prospective Studies
  • Rituximab
  • Treatment Outcome
  • Vincristine (administration & dosage)

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