Multicenter Phase 2 Study of Reduced-Dose CHOP Chemotherapy Combined With Rituximab for Elderly Patients With Diffuse Large B-Cell Lymphoma.

Abstract

INTRODUCTION:

Elderly patients are more prone to encounter some adverse factors when they receive chemotherapy compared to younger patients. Addition of rituximab to a reduced dose (RD) of cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) chemotherapy might improve patient outcomes with an improved toxicity profile when provided to elderly patients with diffuse large B-cell lymphoma.

PATIENTS AND METHODS:

A total of 53 patients aged ≥ 65 years with diffuse large B-cell lymphoma diagnosed between August 2012 and December 2014 were enrolled onto this study. RD-R-CHOP regimen consisted of rituximab at 375 mg/m2, cyclophosphamide at 600 mg/m2, doxorubicin at 30 mg/m2, and vincristine at 1 mg on day 1 of each cycle and 40 mg of prednisone on days 1 to 5. Patients received granulocyte colony-stimulating factor if they experienced grade 3/4 neutropenia or febrile neutropenia during any cycle.

RESULTS:

The median follow-up duration was 18 months (range, 1-44 months). Complete response and overall response rates were 64.1% and 81.1%, respectively. Three-year event-free and overall survival rates were 45.7% ± 8.4% and 62.7% ± 8.1%, respectively. Grade 3/4 neutropenia occurred in 20 patients (37.7%), while febrile neutropenia occurred in 7 patients (20.7%).

CONCLUSION:

Outcomes of RD-R-CHOP chemotherapy were comparable to those of standard-dose R-CHOP or previous dose-adjusted R-CHOP chemotherapy. In the future, strategies such as tailored therapy based on geriatric assessment results are needed to determine the chemotherapeutic dosage.

• Authors: Sungwoo Park, Jae-Cheol Jo, Young Rok Do, Deok-Hwan Yang, Sung-Nam Lim, Won-Sik Lee, Won Seog Kim, Ho Sup Lee, Dae-Sik Hong, Hyo Jung Kim, Ho-Jin Shin
• Journal: Clinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 19 Issue 3 Pg. 149-156 (03 2019) ISSN: 2152-2669 [Electronic] United States
• PMID: 30581162 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)
• Copyright: Copyright © 2018 Elsevier Inc. All rights reserved.

Chemical References

• R-CHOP protocol
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (pharmacology, therapeutic use)
• Cyclophosphamide (pharmacology, therapeutic use)
• Doxorubicin (pharmacology, therapeutic use)
• Female
• Humans
• Lymphoma, Large B-Cell, Diffuse (drug therapy, pathology)
• Male
• Prednisone (pharmacology, therapeutic use)
• Rituximab (pharmacology, therapeutic use)
• Survival Rate
• Treatment Outcome
• Vincristine (pharmacology, therapeutic use)