title: Fludarabine-containing chemotherapy for patients with previously untreated low-grade non-Hodgkin's lymphoma.
abstract: BACKGROUND
  The clinical efficacy and safety of fludarabine combination chemotherapy was investigated for the treatment of previously untreated patients with low-grade (NHL).
  
  
  METHODS
  Twenty-five patients who were newly diagnosed as low-grade NHL were treated with fludarabine combination chemotherapy. Fludarabine combination regimens consisted of fludarabine, mitoxantrone and dexamethasone or fludarabine, cyclophosphamide and mitoxantrone with or without rituximab and repeated every 4 weeks.
  
  
  RESULTS
  The median age was 60 years (range, 35-77 years), with 13 of 25 patients (52%) ≥60 years of age. Seven of 25 patients (28%) with an intermediate risk follicular lymphoma international prognostic index (FLIPI) and 9 of 25 patients (36%) with a high risk FLIPI were enrolled in this study. The delivered median number of chemotherapy was six (range, 2-9 cycles). The overall response rate with fludarabine-based treatment was 88%, including 52% complete remission and 36% partial remission. During the median follow-up of 19 months, the estimated 2-year event-free survival was 63±10% (95% CI, 43-83) and the 2-year overall survival was 78±9% (95% CI, 60-96). Fludarabine combination chemotherapy was frequently associated with grade 3 or 4 neutropenia in 84% patients. However, neutropenic infection was observed in only one (4%) patient. Four patients (16%) showed grade 3 or more non-hematologic toxicities, such as acute coronary syndrome, intracranial hemorrhage, anaphylaxis and gastric cancer.
  
  
  CONCLUSIONS
  Fludarabine-combination treatment was a highly active regimen with well toleration in untreated low-grade NHL.
authors: Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors: Jae-Sook
authors: JS
authors: Ahn
authors: Deok-Hwan
authors: DH
authors: Yang
authors: Sung-Hoon
authors: SH
authors: Jung
authors: Soo-Young
authors: SY
authors: Bae
authors: Huong Thi Thanh
authors: HT
authors: Tran
authors: Hyung Chul
authors: HC
authors: Park
authors: Ha-Na
authors: HN
authors: Kim
authors: Yeo-Kyeoung
authors: YK
authors: Kim
authors: Hyeoung-Joon
authors: HJ
authors: Kim
authors: Je-Jung
authors: JJ
authors: Lee