2 research outputs found
R-Bendamustine in the treatment of nodular lymphocyte-predominant Hodgkin lymphoma
Peer reviewe
Treatment of diffuse large Bâcell lymphoma in elderly patients:replacing doxorubicin with either epirubicin or etoposide (VPâ16)
Abstract
Diffuse large Bâcell lymphoma (DLBCL) is the most common type of lymphoma. The standard therapy for DLBCL is RâCHOP. The current 5âyear overall survival is 60% to 70% using standard frontline therapy. However, the use of doxorubicin and its cardiotoxicity is a major clinical problem and preexisting cardiac disease may prevent the use of doxorubicin. Age greater than 65 years is a significant risk factor for anthracyclineâinduced cardiotoxicity, and therefore, the use of RâCHOP is often withheld from elderly patients. The feasibility of replacing doxorubicin with either epirubicin or etoposide in patients who have risk factors for heart complications is analyzed here. Clinical data of 223 DLBCL patients were retrospectively collected from hospital records. Fiftyâfive patients were treated with RâCHOP, 105 with RâCIOP (epirubicin instead of doxorubicin), 17 with RâCEOP (etoposide instead of doxorubicin), and 31 with RâCHOEP. Matchedâpair analysis was carried out between 30 patients treated with RâCEOP and RâCHOP. For all patients, the 2âyear progressionâfree survival (PFS) was 73.6%. In patients treated with RâCHOP, the 2âyear PFS was 84.2%, with RâCIOP 64.4%, with RâCEOP 87.7%, and with RâCHOEP 83.2%. In matchedâpair analysis, the 2âyear PFS was 92.3% with RâCHOP and 86.2% with RâCEOP. The 2âyear disease specific survival was 100% with RâCHOP and 86.2% with RâCEOP. In conclusion, RâCEOP offers reasonable PFS and disease specific survival in the treatment of DLBCL and good disease control can be achieved in elderly patients. Elderly patients with impaired cardiac function could benefit from the use of RâCEOP instead of RâCHOP. The results with RâCIOP were unsatisfactory, and we do not recommend using this protocol in elderly patients with cardiac disease