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

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

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish
Pages (from-to)1081-1086
Number of pages6
JournalLeukemia and Lymphoma
Issue number6
Publication statusPublished - Jun 2008


  • Doxorubicin
  • Frail patients
  • Liposomal doxorubicin
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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