title: Fludarabine-Mitoxantrone-Rituximab regimen in untreated indolent non-follicular non-Hodgkin's lymphoma: experience on 143 patients.
abstract: Indolent non-follicular lymphomas (inFLs) are generally regarded as incurable, apart from extranodal mucosa-associated lymphatic tissue lymphomas, which can be partially cured by surgery, local radiotherapy, or antibiotic treatment. The aim of the present study was to test the degree of effectiveness and the safety of the regimen containing fludarabine, mitoxantrone, and rituximab (FMR) in inFL patients considering all the different entities belonging to this group. An observational retrospective study was conducted on 143 inFL patients providing that their first chemoimmunotherapy performed was FMR regimen and diagnosis from September 2000 to March 2011. There were 32 small lymphocytic lymphomas and 111 marginal zone lymphomas. At the end of treatment, overall response rate was 96.5% with 88% of complete responses (CR) and 8.5% of partial responses. With a median follow-up of 48 months, 10 out of 125 (8%) CR patients had disease relapse, yielding an estimated 9-year disease-free survival (DFS) of 74.9% and an estimated 10-year overall survival of 92.8%. The estimated 9-year progression free survival was 70.5%. The 10 relapsed patients showed lymphoma recurrence within 52 months: after this time, the DFS curve presented a plateau configuration. Only two (1.4%) patients developed a secondary hematological neoplasia. This study showed promising findings for the use of a fludarabine-based regimen in combination with rituximab in the front-line treatment of symptomatic inFL with a noteworthy high percentage of CR associated to an interesting long-term DFS and favorable acute and long-term safety profile.
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Zinzani
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Pellegrini
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Broccoli
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Letizia
authors.initials: L
authors.lastname: Gandolfi
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Stefoni
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Casadei
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Maglie
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Lisa
authors.initials: L
authors.lastname: Argnani
authors.affiliation: Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Pileri
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008942:Mitoxantrone / Q000008:administration & dosage*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage*; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000069283:Rituximab; D008942:Mitoxantrone; D014740:Vidarabine; C024352:fludarabine
keywords: fludarabine; indolent non-follicular lymphoma; mitoxantrone; rituximab; untreated