Treatment of patients with high-grade non-Hodgkin’s lymphoma aged over 70 years with an all-oral regimen combining idarubicin, etoposide and alkylators
✍ Scribed by Enrica Morra; Livio Gargantini; Annamaria Nosari; Luciana Barbarano; Ester Pungolino; Luca Santoleri; Patrizia Bernuzzi
- Book ID
- 104374970
- Publisher
- Elsevier Science
- Year
- 2000
- Tongue
- English
- Weight
- 75 KB
- Volume
- 35
- Category
- Article
- ISSN
- 1040-8428
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✦ Synopsis
In elderly patients age-specific comorbidity often reduces the possibility of administering intensive chemotherapy and of obtaining response to treatment. Therefore, chemotherapy must differ from that for non-elderly patients, while maintaining the primary goal of a complete clinical response. We treated 19 patients over the age of 70 years (median age 75 years, range 70-86) with stage II-IV high-grade non-Hodgkin's lymphoma (NHL) with a combination regimen including idarubicin plus etoposide and prednimustine (or chlorambucil +prednisone), all administered orally on an outpatient basis. The therapeutic schedule included six 5-day courses of idarubicin 20 mg/sqm on day 1 (or 10 mg/sqm on days 1 and 3 in the nine patients last treated), etoposide 60 mg/sqm/12 h days 2-5, prednimustine 60 mg/sqm days 2 -5, G-CSF 300 mg/day from day +7 until PMN \1000/ml. In ten patients prednimustine was replaced by chlorambucil 10 mg/sqm, days 2 -5, and prednisone 50 mg days 2 -5, because of non-availability of the drug. Of the 19 patients submitted to this regimen 15 (79%) obtained a clinical response: eight reached a complete response (CR), and seven a partial response (PR). Hematologic toxicity was generally mild. Only three patients had to be hospitalised for infection. Except alopecia, non-hematologic toxicities were negligible. At a median follow-up of 16 months, five of eight patients who obtained CR relapsed (median CR duration 7 months). The actuarial median survival is 34 months (range 6-46). This study demonstrates the feasibility and efficacy of an all-oral regimen including idarubicin, plus etoposide and prednimustine (or chlorambucil +prednisone) in NHL patients aged over 70 years.