Since
anthracyclines were introduced in the treatment of
non-Hodgkin's lymphoma in the late 1960s, they have been acknowledged as a cornerstone in the management of the disease and, in particular, of aggressive
lymphomas. The high efficacy of
anthracycline-containing regimens must, however, be balanced against the
drug-related toxicity, which mainly affects the cardiovascular system and represents a major concern for clinicians, especially in the treatment of elderly patients. Patients' outcomes could be further improved, particularly for those at high risk of
cardiotoxicity, by substituting
liposomal doxorubicin for conventional
doxorubicin. This approach has already been tested and shown to be effective in several
cancers, especially in different subsets of patients with
diffuse large B-cell lymphoma. The use of
liposomal doxorubicin in combination regimens for other conditions, such as
follicular lymphoma and splenic marginal zone
lymphoma, is also under investigation, and early results are promising.