Full Dose Chop Chemotherapy in Elderly Patients with Non-Hodgkin's Lymphoma

Epelbaum, Ron; Haim, Nissim; Leviov, Michelle; Ben-Shahar, Menachem; Ben-Arie, Yehudith; Dror, Yehoshua; Faraggi, David

doi:10.3109/02841869509093644

Cited by 25 publications

(11 citation statements)

References 26 publications

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“…Initiatives to improve cytotoxic delivery without compromising benefit have led investigators to develop weekly, multiagent chemotherapy regimens. [20][21][22][23]25,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55] Improvements in supportive care enable the delivery of chemotherapy at standard doses and intensity to deliver maximum benefit to patients. 56 The minimum age of entry of 60 was chosen because patients younger than this were eligible for high-dose regimens and because this age carried prognostic significance in the international prognostic index (IPI) analyses.…”

Section: Discussionmentioning

confidence: 99%

Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO

Mainwaring

Cunningham

Gregory

et al. 2001

Blood

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A prospective, multicenter, randomized trial was undertaken to compare the efficacy and toxicity of adriamycin with mitoxantrone within a 6-drug combination chemotherapy regimen for elderly patients (older than 60 years) with highgrade non-Hodgkin lymphoma (HGL) given for a minimum of 8 weeks. A total of 516 previously untreated patients aged older than 60 years were randomized to receive 1 of 2 anthracycline-containing regimens: adriamycin, 35 mg/m 2 intravenously (IV) on day 1 (n ‫؍‬ 259), or mitoxantrone, 7 mg/m 2 IV on day 1 (n ‫؍‬ 257); with prednisolone, 50 mg orally on days 1 to 14; cyclophosphamide, 300 mg/m 2 IV on day 1; etoposide, 150 mg/m 2 IV on day 1; vincristine, 1.4 mg/m 2 IV on day 8; and bleomycin, 10 mg/m 2 IV on day 8. Each 2-week cycle was administered for a minimum of 8 weeks in the absence of progression. Forty-three patients were ineligible for analysis. The overall and complete remission rates were 78% and 60% for patients receiving PMitCEBO and 69% and 52% for patients receiving PAdriaCEBO (P ‫؍‬ .05, P ‫؍‬ .12, respectively). Overall survival was significantly better with PMitCEBO than PAdriaCEBO (P ‫؍‬ .0067). However, relapse-free survival was not significantly different (P ‫؍‬ .16)

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Section: Discussionmentioning

confidence: 99%

Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO

Mainwaring

Cunningham

Gregory

et al. 2001

Blood

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“…[1][2][3][4] However, multiple studies have been proven that age per se is not a contraindication to aggressive treatment if cure is the endpoint. [5][6][7][8][9] Diffuse large-cell lymphoma (DLCL) are the most frequent subtype of malignant lymphoma and more than 50% of the patients are Ͼ60% years old at diagnosis. 1,2 The standard treatment of DLCL is combined therapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or similar regimens, including other anthracyclines, such as epirubicin and mitoxantrone.…”

Section: Introductionmentioning

confidence: 99%

Rituximab and Escalated Chemotherapy in Elderly Patients with Aggressive Diffuse Large-Cell Lymphoma: A Controlled Clinical Trial

Avilés

Nambo

Castañeda

et al. 2007

Cancer Biotherapy and Radiopharmaceuticals

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The treatment of elderly patients with aggressive malignant lymphoma has not been defined. The addition of rituximab to conventional chemotherapy has been reported to improve the outcome, but most patients have good prognostic factors (performance status < 2, no severe associated diseases, low or low-intermediate clinical risk). Thus, we developed a combined regimen, including escalated doses of anthracycline and rituximab. The endpoint was to improve event-free survival (EFS) and overall survival. Two hundred and four (204) patients were randomly assigned to receive an escalated chemotherapy regimen (CEOP) with escalated dose of epirubicin, compared to the same regimen and addition of rituximab. All patients had poor prognostic factors: high- or high-intermediate clinical risk, poor performance status, bulky disease, and more than 2 with extranodal involvement. In an intent-to-treat analysis, all patients were evaluable for efficacy and toxicity. The complete response rates were similar in both arms: 74% in chemotherapy and 78% in the rituximab + chemotherapy program. EFS and overall survival were similar: 77% and 84%, respectively, in combined chemotherapy and 75% and 81% in the rituximab-chemotherapy regimen. Toxicity was mild and well tolerated. In elderly patients with diffuse large-cell lymphoma and poor prognostic factors, rituximab did not improve their outcome.

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“…In order to maintain an adequate DI, G-CSF was administered with CHOP in the present study. Epelbaum et al [5] reported that the use of CHOP without initial dose reduction is feasible in patients aged 65-74 years, resulting in a high DI (a median of 0.89 after six cycles). Tirelli et al [17] treated patients aged 70 years or older with intermediate-or high-grade NHL using full-dose and 75% dose CHOP therapy when the performance status was 0-1 and 2-3, respectively.…”

Section: Discussionmentioning

confidence: 97%

Full-dose CHOP chemotherapy combined with granulocyte colony-stimulating factor for aggressive non-Hodgkin's lymphoma in elderly patients: a prospective study

Niitsu

Iijima

2001

Annals of Hematology

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We assessed the efficacy and safety of full-dose CHOP regimen plus granulocyte colony-stimulating factor to treat aggressive non-Hodgkin's lymphoma in elderly patients. Forty-two patients with untreated disease were included in this study, aged 70-79 years, with stage II or higher disease and a performance status of 0-3, without severe organ dysfunction. Of the 40 patients who could be evaluated 87.5% achieved complete remission, with a 4-year survival rate of 69% and a 3-year progression-free survival rate of 49%. When stratified by the International prognostic Index, the 4-year survival rate was 90.9% for the low and low-intermediate risk group and 41.3% for the high-intermediate and high risk group, whereas the 3-year progression survival rate was 87.7% and 11.3%, respectively. Grade 3 or 4 hematological toxicity was found in 31 instances of granulocytopenia (77.5%) and 7 of anemia (17.5%). Nonhematological toxicity of grade 3 or 4 included pneumonia in two patients, heart failure in one, and gastrointestinal bleeding in one. Full-dose CHOP regimen with granulocyte colony-stimulating factor support could achieve a high-dose intensity in elderly patients whose general physical condition was good and hence achieved a high complete remission rate, but the disease often recurred within 2 years. Consequently, a new therapeutic strategy needs to be established, particularly for patients with high-intermediate or high risk.

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Full Dose Chop Chemotherapy in Elderly Patients with Non-Hodgkin's Lymphoma

Cited by 25 publications

References 26 publications

Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO

Mitoxantrone is superior to doxorubicin in a multiagent weekly regimen for patients older than 60 with high-grade lymphoma: results of a BNLI randomized trial of PAdriaCEBO versus PMitCEBO

Rituximab and Escalated Chemotherapy in Elderly Patients with Aggressive Diffuse Large-Cell Lymphoma: A Controlled Clinical Trial

Full-dose CHOP chemotherapy combined with granulocyte colony-stimulating factor for aggressive non-Hodgkin's lymphoma in elderly patients: a prospective study

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