JOURNAL ARTICLE

Rituximab plus 70% cyclophosphamide, doxorubicin, vincristine and prednisone for Japanese patients with diffuse large B-cell lymphoma aged 70 years and older

Akiko Meguro, Katsutoshi Ozaki, Kazuya Sato, Iekuni Oh, Shinichiro Fujiwara, Rie Hosonuma, Miyuki Sasazaki, Yuji Kikuchi, Yuji Hirata, Chihiro Yamamoto, Mitsuyo Uesawa, Hiroyuki Kobayashi, Haruko Matsu, Hiroshi Okabe, Eisuke Uehara, Akinori Nishikawa, Raine Tatara, Kaoru Hatano, Chizuru Yamamoto, Tomohiro Matsuyama, Masaki Toshima, Masuzu Ueda, Ken Ohmine, Takahiro Suzuki, Masaki Mori, Tadashi Nagai, Kazuo Muroi, Keiya Ozawa
Leukemia & Lymphoma 2012, 53 (1): 43-9
21864040
In the rituximab era, several large studies have suggested that full-dose rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) might be the best treatment for patients with diffuse large B-cell lymphoma (DLBCL) aged 60 years and older. However, it remains unclear whether this is also the case for those aged 70 years and older. Previously untreated patients with DLBCL aged 70 years and older (elderly) were treated with R-70%CHOP, and patients younger than 70 years (younger) were treated with full-dose R-CHOP every 3 weeks, for a total of 6-8 cycles. Complete remission (CR) rates in elderly versus younger patients were 75 vs. 78% (p = 0.7), respectively. The 3-year overall survival, event-free survival and progression-free survival of elderly versus younger patients were 58 vs. 78% (p < 0.05), 45 vs. 70% (p < 0.05) and 64 vs. 72% (p = 0.43), respectively. Severe adverse events were more frequent in the elderly, even with the dose reduction in that age group. Three-year PFS with R-70%CHOP for patients aged 70 years and older was not significantly worse than that with full-dose R-CHOP for younger patients, suggesting that R-70% CHOP might be a reasonable choice for patients with DLBCL aged 70 years and older, especially for those with comorbidities.

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