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, Paul N.; Cunningham, David; Gregory, Walter M.; Hoskin, Peter; Hancock, Barry W.; Norton, A. J.; MacLennan, Ken; Smith, Paul J.; Hudson, G. Vaughan; Linch, David C.

doi:10.1182/blood.v97.10.2991

Cited by 32 publications

(11 citation statements)

References 63 publications

(74 reference statements)

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“…21,22 In contrast to those results, analysis of the effect on survival of chemotherapy regimens that adriamycin-based or not had no effect on PFS (p= 0.32) and OS (p= 0.80) ın our study. Also in Davis CC et all.…”

Section: International Journal Of Hematology and Oncologycontrasting

confidence: 89%

Anthracyclin – Based Chemotherapy in Patients with Non-Hodgkin Lymphoma Aged Over 75

Sarici¹

2016

UHOD

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The optimal treatment of non-Hodgkin lymphoma (NHL) in elderly patients is controversial. In this study, we evaluated the outcomes for elderly patients who were treated with combined chemotherapy regimens. Patients with lymphoma aged over 75 treated at our Cancer Institute between 2005 and 2014 were evaluated retrospectively. Demographic data were collected from 76 elderly lymphoma cases receiving Rituximab-Chemotherapy, Chemotherapy only or Rituximab only. Survival or death during treatment were recorded, and lengths of progression-free survival (PFS) and overall survival (OS) were calculated. Seventy-six elderly patients with lymphoma were enrolled, 51.4% (n= 39) male and 48.6% (n= 37) female. Median age at diagnosis was 79 (75-95) years. Histopathological examination revealed diffuse large B cell lymphoma (DLBCL) in 52% (n= 40) of patients, follicular lymphoma in 21% (n= 16), marginal zone lymphoma in 10.5% (n= 8), mantle cell lymphoma in 5.3% (n= 4), and T cell lymphoma in 9.2% (n= 7). Median PFS and median OS were 50.1 and 45.9 months, respectively. In this trial, PFS and OS levels in the high grade lymphoma were not significantly different from those in the low and intermediate grade groups (p= 0.16 and p= 0.49 respectively). Comorbidity did not have a significant effect on PFS or OS (p= 0.71 and p= 0.93). In conclusion, anthracyclin-based chemotherapy regimens are not significantly better than the others in terms of PFS (p= 0.32) and OS (p= 0.8). Survival outcomes of anthracyclin-based chemotherapy regimens in elderly lymphoma patients are similar to those of non-anthracycline-based chemotherapy regimens.

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Section: International Journal Of Hematology and Oncologycontrasting

confidence: 89%

Anthracyclin – Based Chemotherapy in Patients with Non-Hodgkin Lymphoma Aged Over 75

Sarici¹

2016

UHOD

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“…19 In contrast to these findings a large study comparing mitoxantrone (7 mg/m 2 ) with doxorubicin (35 mg/m 2 ) in a multiagent weekly regimen in 473 eligible patients older than 60 years with high-grade lymphoma was recently published. 43 In that study, CR rates and overall but not relapse-free survival were better in patients receiving the mitoxantrone-containing regimen. In addition, leukopenia and thrombocytopenia were more common among patients given doxorubicin although severe infections did not differ between the treatment groups.…”

Section: Addition Of G-csfmentioning

confidence: 91%

CHOP is superior to CNOP in elderly patients with aggressive lymphoma while outcome is unaffected by filgrastim treatment: results of a Nordic Lymphoma Group randomized trial

Ösby

Hagberg

Kvaløy

et al. 2003

Blood

174

103

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This study was designed to test the hypothesis that administration of granulocyte colony-stimulating factor (G-CSF; filgrastim) during induction chemotherapy with CHOP (cyclophosphamide, vincristine, doxorubicin, prednisone) or CNOP (doxorubicin replaced with mitoxantrone) in elderly patients with aggressive nonHodgkin lymphoma (NHL) improves time to treatment failure (TTF), complete remission (CR) rate, and overall survival (OS). Furthermore, the efficacy of CHOP versus CNOP chemotherapy was compared. A total of 455 previously untreated patients older than 60 years with stages II to IV aggressive NHL were included in the analysis. Patients (median age, 71 years; range, 60-86 years) were randomized to receive CHOP (doxorubicin 50 mg/m 2 ) or CNOP (mitoxantrone 10 mg/m 2 ) with or without G-CSF (5 g/kg from day 2 until day 10-14 of each cycle every 3 weeks; 8 cycles). Forty-seven patients previously hospitalized for class I to II congestive heart failure were randomized to receive CNOP with or without G-CSF (not included in the CHOP versus CNOP analysis). The CR rates in the CHOP/CNOP plus G-CSF and CHOP/CNOP groups were the same, 52%, and in the CHOP with or without G-CSF and CNOP with or without G-CSF groups, 60% and 43% (P < .001), respectively. No benefit of G-CSF in terms of TTF and OS could be shown (P ‫؍‬ .96 and P ‫؍‬ .22, respectively), whereas CHOP was superior to CNOP (TTF/OS P < .001).The incidences of severe granulocytopenia (World Health Organization grade IV) and granulocytopenic infections were higher in patients not receiving G-CSF. The cumulative proportion of patients receiving 90% or more of allocated chemotherapy was higher (P < .05) in patients receiving G-CSF. Concomitant G-CSF treatment did not improve CR rate, TTF, or OS. Patients receiving CHOP fared better than those given CNOP chemotherapy.

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“…A prospective, multicenter randomized trial was undertaken by the British National Lymphoma Investigation (BNLI) [79] to compare the efficacy and toxicity of doxorubicin with mitoxantrone with a 6-drug chemotherapy regimen for patients older than 60 years with high-grade non-Hodgkin's lymphoma given for a minimum of 8 weeks. The study was conducted on 516 previously untreated patients.…”

Section: Randomized Clinical Trialsmentioning

confidence: 99%

European experiences on aggressive non-Hodgkin?s lymphoma in elderly patients

Fratino

Bernardi

2004

Critical Reviews in Oncology/Hematology

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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

Cited by 32 publications

References 63 publications

Anthracyclin – Based Chemotherapy in Patients with Non-Hodgkin Lymphoma Aged Over 75

Anthracyclin – Based Chemotherapy in Patients with Non-Hodgkin Lymphoma Aged Over 75

CHOP is superior to CNOP in elderly patients with aggressive lymphoma while outcome is unaffected by filgrastim treatment: results of a Nordic Lymphoma Group randomized trial

European experiences on aggressive non-Hodgkin?s lymphoma in elderly patients

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