VNCOP-B regimen in the treatment of high-grade non-Hodgkin's lymphoma in the elderly.
BACKGROUND
Age is an important factor, especially in patients with advanced lymphoma who require more intensive and extensive therapy for any possible chance of cure. In fact, attenuation of treatment to diminish treatment-related toxicity decreases the capacity of the therapy to effect a cure.


METHODS
Between December, 1991 and February 1993, 29 previously untreated patients 60 years and older with high-grade non-Hodgkin's lymphoma (HG-NHL), according to the Kiel classification, were treated with a combination therapy including cyclophosphamide, mitoxantrone, vincristine, etoposide, bleomycin, and prednisone (VNCOP-B).


RESULTS
Twenty-two patients achieved a complete pathologic remission and 5 had a partial response, with a reduction of more than 50% of tumor-related manifestations. Only two cases were resistant to VNCOP-B. Overall survival was 75%, with a median follow-up of 13 months from diagnosis; four of the patients who achieved complete response relapsed after a median follow-up of 11 months from the completion of treatment. Clinical and hematologic toxicity was irrelevant: in 12 patients, neutropenia was responsible for a temporary interruption of therapy for 1-2 weeks.


CONCLUSIONS
This regimen was effective in inducing a good remission rate with moderate toxic effects in elderly patients with HG-NHL, but a longer follow-up is warranted before definitive conclusions can be drawn.
Zinzani
P L
PL
Institute of Hematology L. e A. Seràgnoli, University of Bologna, Italy.
Bendandi
M
M
Gherlinzoni
F
F
Mazza
P
P
Salvucci
M
M
Aitini
E
E
Miggiano
M C
MC
Gozzetti
A
A
Tura
S
S
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage / Q000009:adverse effects; D009503:Neutropenia / Q000139:chemically induced; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D012074:Remission Induction; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D001761:Bleomycin; D014750:Vincristine; D005047:Etoposide; D003520:Cyclophosphamide; D008942:Mitoxantrone; D011241:Prednisone