Dose-Dense CHOP plus Rituximab (R-CHOP14) for the Treatment of Elderly Patients with High-Risk Diffuse Large B Cell Lymphoma: A Pilot Study

Vol. 115, No. 1-2, 2006

Free Abstract Article (Fulltext) Article (PDF 114 KB)

Original Paper

Dose-Dense CHOP plus Rituximab (R-CHOP14) for the Treatment of Elderly Patients with High-Risk Diffuse Large B Cell Lymphoma: A Pilot Study
Luigi Rigacci^a, Luca Nassi^a, Renato Alterini^a, Valentina Carrai^a, Giovanni Longo^a, Franco Bernardi^a, Varesco Martini^b, Alberto Bosi^a

^aDepartment of Hematology, Careggi Hospital and University of Florence, Florence, and
^bOncology Unit, Serristori Hospital, Figline Valdarno, Italy

Address of Corresponding Author

Acta Haematol 2006;115:22-27 (DOI: 10.1159/000089461)

Key Words

Dose-dense CHOP
Elderly patients
High-risk IPI

Abstract

Background: Aggressive non-Hodgkin's lymphomas (NHL) require intensive therapies which seemed impracticable in elderly patients. Dose reduction and therapy attenuation reduced treatment-related toxicity, but also decreased therapeutic efficacy. In elderly patients too, the achievement of complete remission is the most important prognostic factor affecting outcome. Therefore, we have treated elderly patients with a dose-intensified protocol. Aim of the study was to verify the feasibility of this scheme in a subset of patients with high-risk aggressive lymphomas. Methods: Between June 2002 and June 2004, 26 patients over the age of 60 years with a diagnosis of aggressive NHL and an intermediate-high or high International Prognostic Index were treated with biweekly CHOP plus rituximab with the support of granulocyte colony-stimulating factors (G-CSF). Results: Seventeen patients (65%) regularly kept the interval between cycles. Haematological and extrahaematological toxicities were moderate in all the patients. Twenty (77%) patients achieved complete remissions, 6 (23%) partial remissions with an overall response rate of 100%. After a median follow-up of 23 months, the overall survival was 79%; after a median follow-up of 17 months, the disease-free survival was 70%. Conclusion: These results confirm that a dose-dense CHOP programme can be administered safely and effectively in a subset of elderly patients with high-risk aggressive NHL. The addition of rituximab could increase the response rate without adding toxicity.

Author Contacts

Luigi Rigacci, MD
Department of Hematology, Careggi Hospital and University of Florence
Viale G.B. Morgagni, 85
IT-50134 Florence (Italy)
Tel. +39 055 4277476, Fax +39 055 412098, E-Mail l.rigacci@dac.unifi.it

Article Information

Received: May 26, 2005
Accepted after revision: July 13, 2005
Number of Print Pages : 6
Number of Figures : 4, Number of Tables : 2, Number of References : 25

Medline Abstract (ID 16424645)

Download Citation

Cited In

This journal is part of the fourth subject package of the Karger

Journal Archive Collection

Information on packages (PDF)
Free sample issues

For non-native English speakers and international authors who would like assistance with their writing before submission, we suggest American Journal Experts for their scientific editing service.