Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience
Abstract Background Rituximab plus combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is broadly accepted as standard for the treatment of diffuse large B-cell lymphoma (DLBCL). Nevertheless, there is sparsely data concerning the management of elderly p...
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| Format: | Article |
| Language: | English |
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BMC
2018-10-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-018-4885-5 |
| _version_ | 1828885463315775488 |
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| author | Roland Christian Schelker Wolfgang Herr Albrecht Reichle Martin Vogelhuber |
| author_facet | Roland Christian Schelker Wolfgang Herr Albrecht Reichle Martin Vogelhuber |
| author_sort | Roland Christian Schelker |
| collection | DOAJ |
| description | Abstract Background Rituximab plus combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is broadly accepted as standard for the treatment of diffuse large B-cell lymphoma (DLBCL). Nevertheless, there is sparsely data concerning the management of elderly patients. Methods We performed a retrospective study of treatment with rituximab and low-dose trofosfamide in elderly patients (≥ 75 years) with DLBCL who were not suitable for R-CHOP or R-CHOP-like regimens or who did not consent to aggressive treatment. The choice regarding the qualification for R-CHOP or R-CHOP-like regimen was left to the estimation of the treating physicians. Results Eleven patients with a median age of 83 years (range, 75–90 years) were included. The age-adjusted international prognostic index was low risk in one patient, low-intermediate in four patients, high-intermediate in three patients, and high risk in 3 patients. All patients were evaluable for response. Five patients (45%) achieved a complete response, three (27%) a partial response, one (9%) stable disease, and two (18%) progressive disease. The estimated 1-yr overall survival was 54.5%, and the estimated 1-yr progression-free survival 45.5%, however, three patients (27%) were alive without evidence of disease at 16–20 months from start of treatment. Main toxicity was leukopenia (36% grade III or IV), whereas grade III/IV non-hematological adverse events did not occur. Conclusions Due to its potency and low toxicity, trofosfamide/rituximab might represent an alternative therapy for DLBCL of elderly patients not suitable for R-CHOP. This observation, however, should be confirmed in a larger patient population within a prospective clinical trial. |
| first_indexed | 2024-12-13T11:27:00Z |
| format | Article |
| id | doaj.art-82138facf3604dfaa2a05a9bfc74b235 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-13T11:27:00Z |
| publishDate | 2018-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-82138facf3604dfaa2a05a9bfc74b2352022-12-21T23:48:09ZengBMCBMC Cancer1471-24072018-10-011811810.1186/s12885-018-4885-5Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experienceRoland Christian Schelker0Wolfgang Herr1Albrecht Reichle2Martin Vogelhuber3Department of Internal Medicine III, Hematology & Oncology, University Hospital RegensburgDepartment of Internal Medicine III, Hematology & Oncology, University Hospital RegensburgDepartment of Internal Medicine III, Hematology & Oncology, University Hospital RegensburgDepartment of Internal Medicine III, Hematology & Oncology, University Hospital RegensburgAbstract Background Rituximab plus combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is broadly accepted as standard for the treatment of diffuse large B-cell lymphoma (DLBCL). Nevertheless, there is sparsely data concerning the management of elderly patients. Methods We performed a retrospective study of treatment with rituximab and low-dose trofosfamide in elderly patients (≥ 75 years) with DLBCL who were not suitable for R-CHOP or R-CHOP-like regimens or who did not consent to aggressive treatment. The choice regarding the qualification for R-CHOP or R-CHOP-like regimen was left to the estimation of the treating physicians. Results Eleven patients with a median age of 83 years (range, 75–90 years) were included. The age-adjusted international prognostic index was low risk in one patient, low-intermediate in four patients, high-intermediate in three patients, and high risk in 3 patients. All patients were evaluable for response. Five patients (45%) achieved a complete response, three (27%) a partial response, one (9%) stable disease, and two (18%) progressive disease. The estimated 1-yr overall survival was 54.5%, and the estimated 1-yr progression-free survival 45.5%, however, three patients (27%) were alive without evidence of disease at 16–20 months from start of treatment. Main toxicity was leukopenia (36% grade III or IV), whereas grade III/IV non-hematological adverse events did not occur. Conclusions Due to its potency and low toxicity, trofosfamide/rituximab might represent an alternative therapy for DLBCL of elderly patients not suitable for R-CHOP. This observation, however, should be confirmed in a larger patient population within a prospective clinical trial.http://link.springer.com/article/10.1186/s12885-018-4885-5Diffuse large B-cell lymphomaRituximabTrofosfamideElderly patients |
| spellingShingle | Roland Christian Schelker Wolfgang Herr Albrecht Reichle Martin Vogelhuber Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience BMC Cancer Diffuse large B-cell lymphoma Rituximab Trofosfamide Elderly patients |
| title | Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience |
| title_full | Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience |
| title_fullStr | Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience |
| title_full_unstemmed | Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience |
| title_short | Low-dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large B-cell lymphoma of the elderly: a single center experience |
| title_sort | low dose trofosfamide plus rituximab is an effective and safe treatment for diffuse large b cell lymphoma of the elderly a single center experience |
| topic | Diffuse large B-cell lymphoma Rituximab Trofosfamide Elderly patients |
| url | http://link.springer.com/article/10.1186/s12885-018-4885-5 |
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