Fludarabine, cyclophosphamide, and rituximab in patients with advanced, untreated, indolent B-cell nonfollicular lymphomas
| Autor: | Francesco Merli, Luigi Rigacci, Umberto Vitolo, Andrea Ferrario, Barbara Olivero, Alessandra Tedeschi, Francesca Rossi, Maria Goldaniga, Giuseppe Rossi, Donato Mannina, Luca Baldini, Enrica Gamba, Alessandro Pulsoni, Caterina Stelitano, Pellegrino Musto |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Lymphoma B-Cell Cyclophosphamide medicine.medical_treatment Neutropenia Gastroenterology Lymphoplasmacytic Lymphoma Antibodies Monoclonal Murine-Derived Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Aged Aged 80 and over Chemotherapy business.industry Middle Aged medicine.disease Fludarabine Surgery Lymphoma Regimen Treatment Outcome Oncology chemotherapy cyclophosphamide fludarabine indolent nonfollicular lymphomas rituximab Female Rituximab business Vidarabine medicine.drug |
| Zdroj: | Cancer. 118:3954-3961 |
| ISSN: | 0008-543X |
| DOI: | 10.1002/cncr.26708 |
| Popis: | BACKGROUND: Indolent nonfollicular non-Hodgkin B-cell lymphomas (INFLs) are clonal mature B-cell proliferations for which treatment has not been defined to date. METHODS: In this phase 2 study of patients with advanced INFL, the authors evaluated the efficacy and safety of first-line rituximab, fludarabine, and cyclophosphamide (FCR) as induction immunochemotherapy (rituximab 375 mg/m2 intravenously on day 1 of each cycle and on days 1 and 14 of cycles 4 and 5; fludarabine 25 mg/m2 intravenously on days 2-4, cyclophosphamide 250 mg/m2 intravenously on Days 2-4) every 28 days for 6 cycles followed by a maintenance phase with 4 infusions of rituximab (375 mg/m2 intravenously on day 1) every 2 months for responders. RESULTS: Forty-seven patients were enrolled. Among 46 evaluable patients (28 men; median age, 59 years), 19 were diagnosed with lymphoplasmacytic lymphoma, 21 were diagnosed with small lymphocytic lymphoma, and 6 were diagnosed with nodal marginal zone lymphoma. The overall response rate after maintenance was 89.1% with a 67.4% complete remission (CR) rate (CR/unconfirmed CR) and a 21.7% partial response rate. After a median follow-up of 40.9 months, the failure-free survival and progression-free survival rates both were 90.1%, and the overall survival rate was 97.4%. The main toxicity was hematologic, and related grade 3 and 4 neutropenia was observed in 55.3% of patients. CONCLUSIONS: FCR induction therapy followed by a short maintenance phase is a highly effective regimen with acceptable toxicity. Cancer 2012. © 2011 American Cancer Society. |
| Databáze: | OpenAIRE |
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