title: Liposome-encapsulated doxorubicin in combination with cyclophosphamide, vincristine, prednisone and rituximab in patients with lymphoma and concurrent cardiac diseases or pre-treated with anthracyclines.
abstract: BACKGROUND
  To assess the efficacy and safety of the combination of non-pegylated liposome-encapsulated doxorubicin (Myocet(R)) with cyclophosphamide, vincristine, prednisone and rituximab (R-COMP) in patients with aggressive non-Hodgkin's B-cell lymphomas.
  
  
  METHODS
  Twenty-one patients were selected for the presence of negative concurrent clinical features such as cardiac comorbidity and/or previous treatment with anthracycline-based regimens. Liposome-encapsulated doxorubicin at a dose of 50 mg/m(2) was administered in association with cyclophosphamide (750 mg/m(2)), vincristine (1.4 mg/m(2)), prednisone (40 mg/m(2)) and rituximab (375 mg/m(2)) every 21 days for four to six cycles unless progression or unacceptable toxicity occurred.
  
  
  RESULTS
  A complete response (CR) was obtained in 16/21 patients (76%), three patients achieved a partial response (14%), with an overall response rate of 90%. Two patients (10%) did not respond to therapy. After a median follow-up of 13 months (range 2-36 months), 2/16 CR patients relapsed, with a disease-free survival (DFS) of 78%.
  
  
  CONCLUSIONS
  The replacement of doxorubicin with its non-pegylated liposomal pharmaceutical analogue was well tolerated and highly effective in inducing remission in this group of patients at high risk for cardiac toxicity or previously treated with anthracyclines. Its high tolerability and low incidence of cardiac events (only one patient) warrants further studies to confirm the clinical benefits of liposomal doxorubicin in this subset of patients.
authors.affiliation: Department of Hematology, Careggi Hospital and University of Florence, Italy. l.rigacci@dac.unifi.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.forename: Silvia
authors.initials: S
authors.lastname: Mappa
authors.forename: Luca
authors.initials: L
authors.lastname: Nassi
authors.forename: Renato
authors.initials: R
authors.lastname: Alterini
authors.forename: Valentina
authors.initials: V
authors.lastname: Carrai
authors.forename: Franco
authors.initials: F
authors.lastname: Bernardi
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
mesh_terms: D000368:Aged; D018943:Anthracyclines / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use* / Q000633:toxicity; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage*; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D008223:Lymphoma / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D011292:Premedication; D000069283:Rituximab; D013318:Stroke Volume; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D018943:Anthracyclines; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone