title: Short-course R-CHOP followed by (90)Y-Ibritumomab tiuxetan in previously untreated high-risk elderly diffuse large B-cell lymphoma patients: 7-year long-term results.
abstract: An update at 7 years was conceived for our multicenter phase II study in which 55 elderly high-risk untreated diffuse large B-cell lymphoma patients were treated with (90)Y-ibritumomab tiuxetan after a short course of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) as long-term follow-up analyses of this combined therapeutic modality are lacking. The overall response rate to the entire regimen was 80%, including 73% (40/55) of complete response (CR) rate and 7% (4/55) of partial response rate. At the time of writing, 24/55 (43.6%) patients experienced a progression disease and 20 of 40 (50%) patients who obtained a CR are still alive in continuous CR. With a median follow-up of 7 years, the disease-free survival was 43.3% and the progression-free survival was 36.1%. The overall survival at 7.9 years was 38.9% (27 deaths mainly because of lymphoma). Two patients developed secondary hematological malignancies, an acute myeloid leukemia and a myelodysplastic syndrome, at 4 and 3 years from radioimmunotherapy, respectively. Our data confirm the feasibility, efficacy and safety of four cycles of R-CHOP followed by radioimmunotherapy consolidation even in the long term: this combination allows dispensing less chemotherapy in a frail group of patients without invalidating response quality and duration.
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Stefoni
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Casadei
authors.affiliation: Division of Hematology, Presidio Ospedaliero 'Ospedali Civili', Brescia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bottelli
authors.affiliation: Division of Hematology, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gaidano
authors.affiliation: Division of Hematology, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Ciochetto
authors.affiliation: Division of Hematology, Cagliari Hospital, Cagliari, Italy.
authors.forename: M G
authors.initials: MG
authors.lastname: Cabras
authors.affiliation: Department of Cellular Biotechnologies and Hematology, 'La Sapienza' University, Roma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ansuinelli
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Argnani
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Broccoli
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Gandolfi
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Pellegrini
authors.affiliation: University of Bologna, Institute of Hematology 'L. e A. Seràgnoli', University of Bologna, Bologna, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Zinzani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D004317:Doxorubicin / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D016499:Radioimmunotherapy; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000009:adverse effects / Q000627:therapeutic use; D015021:Yttrium Radioisotopes / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D015021:Yttrium Radioisotopes; D000069283:Rituximab; C422802:ibritumomab tiuxetan; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone