title: How to treat splenic marginal zone lymphoma (SMZL) in patients unfit for surgery or more aggressive therapies: experience in 30 cases.
abstract: Splenic marginal zone lymphoma (SMZL) is an indolent disease that typically affects elderly patients. Thanks to its outcome, most patients don't need any specific therapy and 'a watch and wait' policy is frequently employed. Treatment is required in symptomatic cases. Splenectomy remains one of the first line options in patients fit for surgery. The best pharmacological strategy has not yet been identified for poor surgical risk cases. Amongst different possible chemotherapeutic approaches, alkylating agents, alone or in association with Rituximab, could employ in 'frail' patients. In the present study, the role of oral cyclophosphamide (100 mg per day for 15 consecutive days, every 30 for a total of six cycles) associated with anti-CD20 monoclonal antibody has been evaluated in 30 newly diagnosed SMZL patients, not fit for splenectomy or more toxic chemotherapic regimens. Overall response rate was 87% (CR 70%; PR 17%). Median PFS was 20 months (range, 1-53), with better outcome for low-risk cases according to IIL score prognostic index. Toxicity profile resulted mild.
authors.affiliation: a Department of Oncology, Transplants and Advances in Medicine , Section of Hematology, University of Pisa , Pisa , Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Cervetti
authors.affiliation: a Department of Oncology, Transplants and Advances in Medicine , Section of Hematology, University of Pisa , Pisa , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ghio
authors.affiliation: a Department of Oncology, Transplants and Advances in Medicine , Section of Hematology, University of Pisa , Pisa , Italy.
authors.forename: Nadia
authors.initials: N
authors.lastname: Cecconi
authors.affiliation: b Department of Oncology, Biostatistical Consulting , University Hospital S. Chiara , Pisa , Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Morganti
authors.affiliation: a Department of Oncology, Transplants and Advances in Medicine , Section of Hematology, University of Pisa , Pisa , Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Galimberti
authors.affiliation: a Department of Oncology, Transplants and Advances in Medicine , Section of Hematology, University of Pisa , Pisa , Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Petrini
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D000069283:Rituximab / Q000008:administration & dosage; D013160:Splenic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D015996:Survival Rate
chemical_list: D000069283:Rituximab; D003520:Cyclophosphamide
keywords: Indolent lymphomas; Rituximab; SMZL