TY - JOUR
T1 - R-COMP 21 for frail elderly patients with aggressive B-cell non-Hodgkin lymphoma
T2 - A pilot study
AU - Visani, Giuseppe
AU - Ferrara, Felicetto
AU - Alesiani, Francesco
AU - Ronconi, Sonia
AU - Catarini, Massimo
AU - D'adamo, Francesca
AU - Guiducci, Barbara
AU - Bernardi, Daniele
AU - Barulli, Sara
AU - Piccaluga, Pierpaolo
AU - Rocchi, Marco
AU - Isidori, Alessandro
PY - 2008/6
Y1 - 2008/6
N2 - 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 ≥2. Fifteen out of 20 patients (75%) had an International Prognostic Index (IPI) score ≥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.
AB - 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 ≥2. Fifteen out of 20 patients (75%) had an International Prognostic Index (IPI) score ≥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.
KW - Doxorubicin
KW - Frail patients
KW - Liposomal doxorubicin
KW - Non-Hodgkin lymphoma
UR - http://www.scopus.com/inward/record.url?scp=46749125451&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=46749125451&partnerID=8YFLogxK
U2 - 10.1080/10428190802043853
DO - 10.1080/10428190802043853
M3 - Article
C2 - 18569635
AN - SCOPUS:46749125451
SN - 1042-8194
VL - 49
SP - 1081
EP - 1086
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 6
ER -