Modified Chemo Effective for Lymphoma in Elderly

Standard-dose rituximab with low-dose CHOP chemotherapy effective for large B-cell lymphoma

FRIDAY, April 8 (HealthDay News) -- A standard dose of rituximab combined with a low dose of CHOP (doxorubicin, cyclophosphamide, vincristine, and prednisone) chemotherapy (R-miniCHOP) in elderly patients with diffuse large B-cell lymphoma offers good efficacy with acceptable levels of toxicity, according to a study published online April 8 in The Lancet Oncology.

Frédéric Peyrade, M.D, from the Centre régional de lutte contre le cancer de Nice in France, and colleagues assessed the safety and efficacy of a reduced dose of CHOP chemotherapy with the standard dose of rituximab in elderly patients (average age, 83 years) with diffuse large B-cell lymphoma. A total of 149 patients received 375 mg/m² rituximab combined with low-dose CHOP (400 mg/m² cyclophosphamide, 25 mg/m² doxorubicin, and 1 mg vincristine) on day one, and 40 mg/m² prednisone on days one to five, of six cycles, at three-week intervals. Patients were followed up for an average of 20 months, and overall survival was measured as the primary end point.

The investigators found that the median overall survival was 29 months and the two-year overall survival rate was 59 percent. Only serum albumin concentration was found to affect overall survival. Two-year progression-free survival was 47 percent, with median progression-free survival of 21 months. Of the 58 deaths during the follow-up period, only 12 were attributed to toxicity of the treatment, and 33 were secondary to lymphoma progression. Hematological toxicity was the most frequently reported side effect.

"R-miniCHOP should be considered as the new standard treatment in this subgroup of patients," the authors write.

Several of the study authors disclosed financial ties to the pharmaceutical industry.

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