Liposomal daunorubicin (DaunoXome) in combination with cyclophosphamide, vincristine and prednisolone (COP-X) as salvage therapy in poor-prognosis non-Hodgkins lymphoma

Autor:	P Cervi, A. Hughes, Stephen M. Kelsey, I. R. Grant, N. C. McBride, A Gray, M. C. Ward, Jamie Cavenagh, M. J. Mills, Adrian C. Newland, Steve Schey
Rok vydání:	2001
Předmět:	Male Cancer Research medicine.medical_specialty Prednisolone Salvage therapy Neutropenia CHOP Gastroenterology immune system diseases hemic and lymphatic diseases Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Mucositis Humans Cyclophosphamide Aged Salvage Therapy Antibiotics Antineoplastic business.industry Lymphoma Non-Hodgkin Daunorubicin Remission Induction Hematology Middle Aged medicine.disease Prognosis Leukemia Lymphocytic Chronic B-Cell Survival Analysis Liposomal daunorubicin Non-Hodgkin's lymphoma Surgery Regimen Treatment Outcome Oncology Therapeutic Equivalency Vincristine Liposomes Female business medicine.drug
Zdroj:	Leukemialymphoma. 42(1-2)
ISSN:	1042-8194
Popis:	We treated 33 patients with a variant of the standard 3 weekly CHOP regime, replacing doxorubicin with liposomal daunorubicin (DaunoXome, NeXstar Pharmaceuticals) 120 mg/m2 (COP-X). Eighteen subjects had relapsed/refractory aggressive NHL and 15 had indolent NHL/CLL. Median number of courses received was 4 (1-8). Thirty-two patients were evaluable for efficacy and 26 (81%) responded. 88% of patients with aggressive NHL responded; three (18%) patients achieved complete remission (CR), 12 (70%) achieved partial remission (PR), 1 (6%) patient had stable disease (SD) and 1 (6%) patient progressed through treatment. Median duration of response for patients with aggressive NHL was 3 months. The response rate in indolent NHL/CLL was 73%. Four (27%) patients achieved CR, 7 (46%) PR and 4 (27%) SD. At two years post treatment, 55% of the patients with indolent NHL/CLL remain progression-free, although 4 patients have proceeded to consolidation therapy. Twenty-seven out of 28 (96%) patients developed neutropenia of short duration following one or more of their treatments. Twenty-three patients developed an infection at some stage during therapy (all associated with neutropenia) and required hospitalisation. There were two toxic deaths (infection) both of which occurred in patients who were neutropenic before starting COP-X. Platelet toxicity was mild in patients with normal platelet counts at the commencement of therapy. Alopecia and mucositis were mild. No clinical evidence of myocardial failure was observed. We conclude that the substitution of DaunoXome for doxorubicin in the CHOP regimen to form COP-X provides excellent efficacy against non-Hodgkin's lymphoma. Response durations were short but comparable to those reported with other regimens. COP-X was well tolerated with some suggestion of reduced non-haematological toxicity. The regimen should be considered as an alternative to CHOP with potentially less non-haematological toxicity, particularly cardiac; further studies are required to evaluate the regimen in this context.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7f4519c12c9d08e9d15cfee8af2aab07 https://pubmed.ncbi.nlm.nih.gov/11699226 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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