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Activity and safety of dose‐adjusted infusional cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy with rituximab in very elderly patients with poor‐prognostic untreated diffuse large B‐cell non‐Hodgkin lymphoma
Author(s) -
Musolino Antonino,
Boggiani Daniela,
Panebianco Michele,
Vasini Giovanna,
Salvagni Stefania,
Franciosi Vittorio,
Ardizzoni Andrea
Publication year - 2010
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.25582
Subject(s) - medicine , international prognostic index , vincristine , prednisone , rituximab , cyclophosphamide , regimen , neutropenia , diffuse large b cell lymphoma , febrile neutropenia , ejection fraction , chemotherapy regimen , surgery , chop , chemotherapy , gastroenterology , lymphoma , heart failure
BACKGROUND: This study was designed to assess the activity and safety of dose‐adjusted infusional cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy with rituximab (DA‐POCH‐R) in elderly patients with poor‐prognostic untreated diffuse large B‐cell non‐Hodgkin lymphoma (DLBCL). METHODS: From April 2006 to November 2009, 23 patients, aged ≥70 years, with an age‐adjusted International Prognostic Index (IPI) of 2 or 3, were enrolled. Only patients with left ventricular ejection fraction (LVEF) ≥50% were allowed. The DA‐POCH‐R regimen was administered every 3 weeks for a minimum of 6 and a maximum of 8 cycles. RESULTS: Median patient age was 77 years (range, 70‐90 years); 83% of patients had Ann Arbor stage III to IV disease. Median LVEF at baseline was 62%. Four (17%) patients had a history of abnormal cardiovascular conditions. Twenty‐one (91%) patients were evaluable for response. The overall response rate was 90%, with a complete response rate of 57%. The 3‐year overall survival and event‐free survival rates were 56% and 54%, respectively. Neutropenia (48%) was the most frequent grade 3 to 4 adverse event (AE); no grade 3 to 4 cardiac AEs were observed. CONCLUSIONS: DA‐POCH‐R was an active and safe combination therapy for patients aged ≥70 years with poor‐prognostic untreated DLBCL. This regimen was a reasonable alternative for elderly patients who were not considered to tolerate standard R‐CHOP treatment. Cancer 2011. © 2010 American Cancer Society.