Cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab versus epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab for the initial treatment of elderly "fit" patients with diffuse large B-cell lymphoma: results from the ANZINTER3 trial of the Intergruppo Italiano Linfomi.

Abstract

We conducted a prospective study to compare epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab (R-miniCEOP) with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab (R-CHOP) for the treatment of "fit" elderly patients with diffuse large B-cell lymphoma (DLBCL). Patients over the age of 65 with stage II-IV DLBCL were screened with a comprehensive geriatric assessment. Patients were randomized to receive six courses of R-miniCEOP (n = 114) or R-CHOP (n = 110). Overall, the rate of complete remission was 70% (p = 0.466). After a median follow-up of 42 months, 5-year event-free survival (EFS) rates were 46% and 48% for R-miniCEOP and R-CHOP, respectively (p = 0.538). Patients older than 72 years and with low-risk disease had a better outcome when treated with R-miniCEOP (p = 0.011). Overall R-CHOP and R-miniCEOP are similarly effective for elderly "fit" patients with DLBCL. The less intense R-miniCEOP may be an acceptable option for the treatment of relatively older patients with low-risk disease.

• Authors: Francesco Merli, Stefano Luminari, Giuseppe Rossi, Caterina Mammi, Luigi Marcheselli, Alessandra Tucci, Fiorella Ilariucci, Annalisa Chiappella, Maurizio Musso, Alice Di Rocco, Caterina Stelitano, Isabel Alvarez, Luca Baldini, Patrizio Mazza, Flavia Salvi, Annalisa Arcari, Alberto Fragasso, Paolo G Gobbi, Anna Marina Liberati, Massimo Federico
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 53 Issue 4 Pg. 581-8 (Apr 2012) ISSN: 1029-2403 [Electronic] United States
• PMID: 21895543 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal, Murine-Derived
• Epirubicin
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Aged
• Aged, 80 and over
• Anemia (chemically induced)
• Antibodies, Monoclonal, Murine-Derived (administration & dosage, adverse effects)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Cyclophosphamide (administration & dosage, adverse effects)
• Disease-Free Survival
• Doxorubicin (administration & dosage, adverse effects)
• Epirubicin (administration & dosage, adverse effects)
• Female
• Follow-Up Studies
• Geriatric Assessment (methods, statistics & numerical data)
• Humans
• Kaplan-Meier Estimate
• Lymphoma, Large B-Cell, Diffuse (drug therapy, pathology)
• Male
• Middle Aged
• Multivariate Analysis
• Neutropenia (chemically induced)
• Prednisone (administration & dosage, adverse effects)
• Proportional Hazards Models
• Prospective Studies
• Rituximab
• Treatment Outcome
• Vincristine (administration & dosage, adverse effects)