title: 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.
authors.affiliation: Division of Hematology, Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Meguro
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Ozaki
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sato
authors.forename: Iekuni
authors.initials: I
authors.lastname: Oh
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Fujiwara
authors.forename: Rie
authors.initials: R
authors.lastname: Hosonuma
authors.forename: Miyuki
authors.initials: M
authors.lastname: Sasazaki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hirata
authors.forename: Chihiro
authors.initials: C
authors.lastname: Yamamoto
authors.forename: Mitsuyo
authors.initials: M
authors.lastname: Uesawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Haruko
authors.initials: H
authors.lastname: Matsu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Okabe
authors.forename: Eisuke
authors.initials: E
authors.lastname: Uehara
authors.forename: Akinori
authors.initials: A
authors.lastname: Nishikawa
authors.forename: Raine
authors.initials: R
authors.lastname: Tatara
authors.forename: Kaoru
authors.initials: K
authors.lastname: Hatano
authors.forename: Chizuru
authors.initials: C
authors.lastname: Yamamoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Matsuyama
authors.forename: Masaki
authors.initials: M
authors.lastname: Toshima
authors.forename: Masuzu
authors.initials: M
authors.lastname: Ueda
authors.forename: Ken
authors.initials: K
authors.lastname: Ohmine
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suzuki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nagai
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.forename: Keiya
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D007970:Leukopenia / Q000139:chemically induced; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000208:ethnology; D008297:Male; D012189:Retrospective Studies; D000069283:Rituximab; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide