title: R-split-CHOP chemotherapy for elderly patients with diffuse large B-cell lymphoma.
abstract: OBJECTIVE
  Chemoimmunotherapy with cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab (R-CHOP) is the standard of care for patients with diffuse large B-cell lymphoma (DLBCL). However, management of elderly patients is challenging as critical comorbidities often account for increased number of treatment-related complications.
  
  
  METHODS
  In the past 8 yrs, we have treated elderly patients with a full-dose R-CHOP regimen by splitting the administration of cyclophosphamide and doxorubicin over 2 days (R-split-CHOP) to reduce peak plasma level. Here, we retrospectively analyzed the results of 30 patients with newly diagnosed DLBCL.
  
  
  RESULTS
  The overall response rate was found to be 87%, the overall survival probability after 3 yrs was 60.6% (95% CI, 42.1%-79.0%), and the progression-free survival probability was 49.7% (95% CI, 30.4%-68.9%). Grade 3/4 infectious complications were reported in 30% of patients, yet no treatment-related deaths occurred.
  
  
  CONCLUSIONS
  We suggest that R-split-CHOP could be a valuable option to safely administer full-dose-intensity R-CHOP to elderly patients at risk of treatment-related complications.
authors.affiliation: Department of Hematology, Oncology and Tumor Immunology, Charite Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Kreher
authors.forename: Felicitas
authors.initials: F
authors.lastname: Lammer
authors.forename: Dieter
authors.initials: D
authors.lastname: Augustin
authors.forename: Antonio
authors.initials: A
authors.lastname: Pezzutto
authors.forename: Claudia D
authors.initials: CD
authors.lastname: Baldus
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012189:Retrospective Studies; D014750:Vincristine / Q000627:therapeutic use
chemical_list: D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone
keywords: DLBCL; R-CHOP; R-split-CHOP; elderly; rituximab