Rituximab plus reduced-dose cyclophosphamide, doxorubicin, vincristine and prednisone (RD R-CHOP) chemotherapy is feasible for very elderly patients (≥80 years) with B-cell lymphoma: analysis of treatment outcome.
OBJECTIVE
The aim of this trial was to evaluate the treatment outcome of reduced-dose (RD)R-CHOP treatment in very elderly patients with B-cell lymphoma.


METHODS
This trial comprised 40 patients, aged ≥80 years, who were diagnosed with B-cell lymphoma and recruited at a single centre from 2007 to 2013. They received four to eight cycles of reduced-dose R-CHOP (rituximab 375 mg/m2Day 0, cyclophosphamide 400 mg/m2Day 1, epirubicin 35 mg/m2Day 1, vincristine 1 mg Day 1 and prednisone 50 mg/m2Days 1-5). The data of treatment responses and survival were collected and analysed comprehensively.


RESULTS
The median age was 83 years old (range, 80-93 years old) and the median follow-up duration was 40.86 months. The overall response rate (ORR) was 87.5%. With a 40.9-month follow-up, 3-year overall survival (OS), 3-year progression free survival (PFS) and 3-year event-free survival (EFS) were 17.2, 46.5 and 39.1%, respectively. Using multivariate analysis, we concluded that age ≥85 years; LVEF ≤70%; M-CIRS score ≥6 and ECOG-PS ≥2 were predictive poor prognostic factors.


CONCLUSIONS
High response rate was concluded on very elderly B-cell lymphoma patients (≥80 years old) with reduced-dose R-CHOP. However, the very elderly patients with poor performance status and more complications benefit less from treatment.
a Department of Medical Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Zhan
Z
Shi
a Department of Medical Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Xi
X
Tang
a Department of Medical Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Jingwen
J
Wang
b Department of Radiation Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Qianwen
Q
Shen
a Department of Medical Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Xi
X
Chen
a Department of Medical Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Jiayan
J
Chen
a Department of Medical Oncology, Hua'dong Hospital , Fu'dan University , Shanghai 200040 , China.
Jie
J
Zhuang
D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016393:Lymphoma, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab / Q000008:administration & dosage; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
Aged; Dose-adjusted; Elderly; Infusional CHOP; Lymphoma; Survival analysis; Treatment outcome