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Biweekly rituximab, cyclophosphamide, vincristine, non‐pegylated liposome‐encapsulated doxorubicin and prednisone (R‐COMP‐14) in elderly patients with poor‐risk diffuse large B‐cell lymphoma and moderate to high ‘life threat’ impact cardiopathy

Authors :
Alfonso Amore
Maria RosariaVilla
Rosaria De Filippi
Gaetano Corazzelli
Filippo Russo
Gianpaolo Marcacci
Antonio Pinto
Anna Lucania
Emanuela Morelli
Ferdinando Frigeri
Lucia Mastrullo
Cristina Becchimanzi
Gaetana Capobianco
Manuela Arcamone
Antonietta Caronna
Francesco Volzone
Corazzelli, G
Frigeri, F
Arcamone, M
Lucania, A
Rosariavilla, M
Morelli, E
Amore, A
Capobianco, G
Caronna, A
Becchimanzi, C
Volzone, F
Marcacci, G
Russo, F
DE FILIPPI, Rosaria
Mastrullo, L
Pinto, A.
Source :
British Journal of Haematology
Publication Year :
2011
Publisher :
Wiley, 2011.

Abstract

This Phase II study assessed feasibility and efficacy of a biweekly R-COMP-14 regimen (rituximab, cyclophosphamide, non-pegylated liposome-encapsulated doxorubicin, vincristine and prednisone) in untreated elderly patients with poor-risk diffuse large B-cell lymphoma (DLBCL) and moderate to high ‘life threat’ impact NIA/NCI cardiac comorbidity. A total of 208 courses were delivered, with close cardiac monitoring, to 41 patients (median age: 73 years, range: 62–82; 37% >75 years) at a median interval of 15·6 (range, 13–29) days; 67% completed all six scheduled courses. Response rate was 73%, with 68% complete responses (CR); 4-year disease-free survival (DFS) and time to treatment failure (TTF) were 72% and 49%, respectively. Failures were due to early death (n = 3), therapy discontinuations (no-response n = 2; toxicity n = 6), relapse (n = 6) and death in CR (n = 3). Incidence of cardiac grade 3–5 adverse events was 7/41 (17%; 95% confidence interval: 8–31%). Time to progression and overall survival at 4-years were 77% and 67%, respectively. The Age-adjusted Charlson Comorbidity Index (aaCCI) correlated with failures (P = 0·007) with patients scoring ≤7 having a longer TTF (66% vs. 29%; P = 0·009). R-COMP-14 is feasible and ensures a substantial DFS to poor-risk DLBCL patients who would have been denied anthracycline-based treatment due to cardiac morbidity. The aaCCI predicted both treatment discontinuation rate and TTF.

Details

ISSN :
13652141 and 00071048
Volume :
154
Database :
OpenAIRE
Journal :
British Journal of Haematology
Accession number :
edsair.doi.dedup.....68e035c38b6501da12b2caee6b9497a8
Full Text :
https://doi.org/10.1111/j.1365-2141.2011.08786.x