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.
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Authors | Giuseppe Visani, Felicetto Ferrara, Francesco Alesiani, Sonia Ronconi, Massimo Catarini, Francesca D'adamo, Barbara Guiducci, Daniele Bernardi, Sara Barulli, Pierpaolo Piccaluga, Marco Rocchi, Alessandro Isidori |
Journal | Leukemia & lymphoma
(Leuk Lymphoma)
Vol. 49
Issue 6
Pg. 1081-6
(Jun 2008)
ISSN: 1029-2403 [Electronic] United States |
PMID | 18569635
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Rituximab
- Vincristine
- Doxorubicin
- Cyclophosphamide
- Prednisone
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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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