Cancer Chemotherapy and Pharmacology

, Volume 69, Issue 5, pp 1165–1172

Addition of rituximab to reduced-dose CHOP chemotherapy is feasible for elderly patients with diffuse large B-cell lymphoma

  • Ho-Jin Shin
  • Joo Seop Chung
  • Moo-Kon Song
  • Seon-Kyeong Kim
  • Sangmin Choe
  • Goon-Jae Cho
Original Article

DOI: 10.1007/s00280-011-1814-6

Cite this article as:
Shin, HJ., Chung, J.S., Song, MK. et al. Cancer Chemother Pharmacol (2012) 69: 1165. doi:10.1007/s00280-011-1814-6

Abstract

Purpose

The aim of this study was to evaluate the efficacy and toxicity of reduced-dose (RD) RCHOP (rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisolone) chemotherapy for elderly patients with diffuse large B-cell lymphoma (DLBCL).

Methods

This study comprised 85 patients, aged ≥60 years, who were diagnosed with DLBCL; patients were enrolled at a single center between June 2004 and December 2009. Patients received either 6 or 8 cycles of RD-RCHOP, spaced 3 weeks apart, at the physician’s discretion. The RD-RCHOP regimen consisted of 375 mg/m2 rituximab, 600 mg/m2 cyclophosphamide, 30 mg/m2 doxorubicin, and 1-mg vincristine on day 1 of each cycle, and 40-mg prednisone on days 1–5. The patients received granulocyte colony-stimulating factor if they experienced grade 4 neutropenia or febrile neutropenia during any cycle.

Results

The average relative dose intensity was 97.3% for doxorubicin and 97.4% for cyclophosphamide. The complete remission (CR) and overall response rate were 67.1 and 89.5%, respectively. The 3-year event-free survival and overall survival rates were 71.9% ± 5.1% and 83.3% ± 5.1%. By using multivariate analyses, we determined that C-reactive protein levels greater than 1.31 mg/dl and the absence of CR were poor prognostic factors. Grade 3 or 4 neutropenia occurred in 35.3% of patients, and febrile neutropenia occurred in only 3 (3.5%) patients.

Conclusions

RD-RCHOP chemotherapy is well tolerated and effective in elderly patients with DLBCL.

Keywords

Rituximab CHOP chemotherapy Diffuse large B-cell lymphoma C-reactive protein 

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Ho-Jin Shin
    • 1
  • Joo Seop Chung
    • 1
  • Moo-Kon Song
    • 1
  • Seon-Kyeong Kim
    • 2
  • Sangmin Choe
    • 3
  • Goon-Jae Cho
    • 1
  1. 1.Division of Hematology-Oncology, Department of Internal Medicine, School of Medicine, Medical Research InstitutePusan National University HospitalBusanKorea
  2. 2.Division of Hematology-Oncology, Department of Internal Medicine, School of MedicinePusan National University Yangsan HospitalYangsanKorea
  3. 3.Division of Clinical Pharmacology, Clinical Research CenterPusan National University HospitalBusanKorea