title: Reduced-dose ICE chemotherapy ± rituximab is a safe and effective salvage therapy for fit elderly patients with diffuse large B-cell lymphoma.
abstract: The risk of developing non-Hodgkin lymphoma increases with age, yet elderly patients are under-represented in clinical trials. Here, we evaluate a combination regimen including ifosfamide, carboplatin and etoposide with or without rituximab (ICE ± R) in 32 fit elderly patients (median age 75.6 years) with relapsed or refractory diffuse large B-cell lymphoma. ICE ± R was generally administered in reduced doses and was well tolerated. The overall response rate (ORR) was 53.1% with a complete response (CR) rate of 40.6%. The median progression free survival (PFS) and overall survival (OS) were 3.9 and 17.0 months, respectively. Patients who responded to ICE ± R achieved median PFS of 47.2 months and OS of 78.9 months. Patients ineligible for autologous transplantation who responded to ICE ± R were treated with additional cycles, and achieved a median PFS of 18.9 months and OS of 21.7 months. Previous response to first-line therapy was the strongest predictor of response, PFS and OS to second-line treatment.
authors.affiliation: a Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel ;
authors.forename: Nadav
authors.initials: N
authors.lastname: Sarid
authors.affiliation: a Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel ;|b Scakler Faculty of Medicine , Tel-Aviv University , Tel Aviv , Israel ;
authors.forename: Erel
authors.initials: E
authors.lastname: Joffe
authors.affiliation: a Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel ;
authors.forename: Lili
authors.initials: L
authors.lastname: Gibstein
authors.affiliation: a Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel ;
authors.forename: Irit
authors.initials: I
authors.lastname: Avivi
authors.affiliation: c Department of Hematology , Hadassah University Hospital , Jerusalem , Israel.
authors.forename: Aaron
authors.initials: A
authors.lastname: Polliack
authors.affiliation: a Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel ;
authors.forename: Chava
authors.initials: C
authors.lastname: Perry
authors.affiliation: a Department of Hematology , Tel Aviv Sourasky Medical Center , Tel Aviv , Israel ;|b Scakler Faculty of Medicine , Tel-Aviv University , Tel Aviv , Israel ;
authors.forename: Yair
authors.initials: Y
authors.lastname: Herishanu
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D016190:Carboplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D015897:Comorbidity; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D009367:Neoplasm Staging; D012189:Retrospective Studies; D000069283:Rituximab / Q000008:administration & dosage; D016879:Salvage Therapy; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000069283:Rituximab; D005047:Etoposide; D016190:Carboplatin; D007069:Ifosfamide
keywords: ICE; diffuse large B-cell lymphoma; elderly; rituximab