Rituximab plus 70% cyclophosphamide, doxorubicin, vincristine and prednisone for Japanese patients with diffuse large B-cell lymphoma aged 70 years and older

Abstract

In the rituximab era, several large studies have suggested that full-dose rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) might be the best treatment for patients with diffuse large B-cell lymphoma (DLBCL) aged 60 years and older. However, it remains unclear whether this is also the case for those aged 70 years and older. Previously untreated patients with DLBCL aged 70 years and older (elderly) were treated with R-70%CHOP, and patients younger than 70 years (younger) were treated with full-dose R-CHOP every 3 weeks, for a total of 6–8 cycles. Complete remission (CR) rates in elderly versus younger patients were 75 vs. 78% (p = 0.7), respectively. The 3-year overall survival, event-free survival and progression-free survival of elderly versus younger patients were 58 vs. 78% (p < 0.05), 45 vs. 70% (p < 0.05) and 64 vs. 72% (p = 0.43), respectively. Severe adverse events were more frequent in the elderly, even with the dose reduction in that age group. Three-year PFS with R-70%CHOP for patients aged 70 years and older was not significantly worse than that with full-dose R-CHOP for younger patients, suggesting that R-70% CHOP might be a reasonable choice for patients with DLBCL aged 70 years and older, especially for those with comorbidities.

Keywords::

• DLBCL
• dose reduction
• elderly
• R-70%CHOP

Acknowledgements

We thank Izumi Chihara, MD, MPH for assistance with statistical analysis.

We thank Riko Homma, MD (Yamagata Prefectural Central Hospital), Shinichi Kako, MD (Saitama Medical Center, Jichi Medical University) and Jiro Akiba, MD (Yamagata Prefectural Kahoku Hospital); Imai Hospital, Oyama Municipal Hospital, Toyonaka Municipal Hospital, Nogi Hospital, Yuai Memorial Hospital, Japanese Red Cross Koga Hospital, Haga Red Cross Hospital, Internal University of Health and Welfare Shioya Hospital, Koganei Chuo Hospital, Ohtawara Red Cross Hospital, Tochigi Cancer Center, Miyata Hospital, Higashisaimata Hospital, Sanokousei General Hospital, Kamituga General Hospital, Ohya Clinic and Komatsuzaki Hospital for providing patient data.

Potential conflict of interest:

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