Alternating R-CHOP and R-cytarabine is a safe and effective regimen for transplant-ineligible patients with a newly diagnosed mantle cell lymphoma
Jazyk angličtina Země Velká Británie, Anglie Médium print-electronic
Typ dokumentu časopisecké články
PubMed
29083050
DOI
10.1002/hon.2483
Knihovny.cz E-zdroje
- Klíčová slova
- PET-CT, elderly patients, high-dose cytarabine, mantle cell lymphoma, rituximab maintenance,
- MeSH
- cyklofosfamid farmakologie terapeutické užití MeSH
- cytarabin farmakologie terapeutické užití MeSH
- doxorubicin farmakologie terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfom z plášťových buněk farmakoterapie patologie MeSH
- myší monoklonální protilátky farmakologie terapeutické užití MeSH
- prednison farmakologie terapeutické užití MeSH
- protokoly protinádorové kombinované chemoterapie farmakologie terapeutické užití MeSH
- rituximab MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vinkristin farmakologie terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cyklofosfamid MeSH
- cytarabin MeSH
- doxorubicin MeSH
- myší monoklonální protilátky MeSH
- prednison MeSH
- R-CHOP protocol MeSH Prohlížeč
- rituximab MeSH
- vinkristin MeSH
Implementation of cytarabine into induction therapy became standard of care for younger patients with mantle cell lymphoma (MCL). On the basis of its beneficial impact, many centers incorporated cytarabine at lower doses also into first-line treatments of elderly patients. We conducted a multicenter observational study that prospectively analyzed safety and efficacy of alternating 3 + 3 cycles of R-CHOP and R-cytarabine for newly diagnosed transplant-ineligible MCL patients. A total of 73 patients were enrolled with median age 70 years. Most patients had intermediate (39.7%) and high-risk (50.7%) disease according to MCL international prognostic index. Rituximab maintenance was initiated in 58 patients. Overall response rate reached 89% by positron emission tomography-computed tomography, including 75.3% complete remissions. Two patients (2.7%) did not complete the induction therapy because of toxicity. Three patients (4.1%) were considered nonresponders, which led to therapy change before completion of induction. Estimated progression-free survival and overall survival were 51.3% and 68.6% at 4 years, respectively. Mantle cell lymphoma international prognostic index, bulky disease (≥ 5 cm), and achievement of positron emission tomography-negativity independently correlated with progression-free survival. Grade 3 to 4 hematologic and nonhematologic toxicity was documented in 48% and 20.5% patients, respectively. Alternation of R-CHOP and R-cytarabine represents feasible and very effective regimen for elderly/comorbid MCL patients. This study was registered at GovTrial (clinicaltrials.gov) NCT03054883.
1st Medical Department Charles University General Hospital Prague Prague Czech Republic
Department of Hematology and Oncology Masaryk University Hospital in Brno Brno Czech Republic
Institute of Nuclear Medicine Charles University General Hospital Prague Prague Czech Republic
Institute of Pathology Charles University General Hospital Prague Prague Czech Republic
Citace poskytuje Crossref.org
Advances in Molecular Biology and Targeted Therapy of Mantle Cell Lymphoma
ClinicalTrials.gov
NCT03054883