Effectiveness of fludarabine, idarubicin and cyclophosphamide (FLUIC) combination regimen for young patients with untreated non-follicular low-grade non-Hodgkin's lymphoma.
In the last years, fludarabine (FLU) alone or in combination with other drugs has been reported to be effective in the treatment of previously untreated low-grade non-Hodgkin's lymphomas (LG-NHL). We report on the therapeutic efficacy and toxicity of a combination of FLU, idarubicin and cyclophosphamide (FLUIC regimen) in untreated non-follicular LG-NHL. We administered a three-drug combination of FLU (25 mg/m2 i.v. on days 1 to 3), idarubicin (14 mg/m2 i.v. on day 1) and cyclophosphamide (200 mg/m2 i.v. on days 1 to 3) to treat 41 young, previously untreated patients with non-follicular LG-NHL. Chemotherapy was repeated every 4 weeks for a total of 6 cycles. Among 41 patients, 24 (59%) were diagnosed with small lymphocytic, 10 (24%) with immnocytoma, and 7 (17%) with marginal zone subtypes. Nineteen (46%) patients achieved complete response (CR) and 21 (51%) partial response, while the remaining 1 (3%) showed no benefit from the treatment. With respect to histology, we observed CR rates of 38% for the small lymphocytic subtype, 40% for the immunocytoma subtype, and 86% for the marginal zone subtype. Estimated 42-month overall survival and relapse-free survival rates were 64% and 100%, respectively. Hematologic grade 3-4 toxicity was seen in 9 (22%) patients; no opportunistic infection or death was associated with administration of the FLUIC regimen. These preliminary data suggest that FLUIC is a very active, well-tolerated regimen for young, untreated patients with advanced non-follicular LG-NHL.
Zinzani
Pier Luigi
PL
Institute of Hematology and Medical Oncology "Seràgnoli", University of Bologna, Bologna, Italy. plzinzo@med.unibo.it
Pulsoni
Alessandro
A
Gentilini
Patrizia
P
Visani
Giuseppe
G
Perrotti
Alessio
A
Molinari
Anna Lia
AL
Guardigni
Luciano
L
Tani
Monica
M
Villivà
Nicoletta
N
Stefoni
Vittorio
V
Alinari
Lapo
L
Martelli
Maurizio
M
Bonifazi
Francesca
F
Pileri
Stefano
S
Tura
Sante
S
Baccarani
Michele
M
D000328:Adult; D000368:Aged; D000375:Aging / Q000502:physiology*; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015255:Idarubicin / Q000009:adverse effects / Q000627:therapeutic use*; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014740:Vidarabine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*
D003520:Cyclophosphamide; D014740:Vidarabine; C024352:fludarabine; D015255:Idarubicin