Department of Hematology, Kishiwada City Hospital, 1001 Gakuhara-cho, Kishiwada City, Osaka 596-8501, Japan.
Arch Gerontol Geriatr. 2010 Sep-Oct;51(2):209-15. doi: 10.1016/j.archger.2009.10.010. Epub 2009 Nov 18.
CHOP (cyclophosphamide, adriamycin, vincristine, and prednisolone) plus rituximab is a standard chemotherapy used to treat patients with aggressive B-cell non-Hodgkin lymphoma (B-NHL). However, among elderly patients, this regimen has not been completely satisfactory in its efficacy and safety. We report our clinical experience in 8 collaborative institutions to determine if the VNCOP-B (etoposide, mitoxantrone, cyclophosphamide, vincristine, prednisolone, and bleomycin) combination therapy plus rituximab was effective and safe to treat elderly patients with aggressive B-NHL. Between September 2004 and December 2007, 23 previously untreated patients, median age 73 years, 50.0% classified as high-intermediate/high-risk on the standard International Prognostic Index (IPI) entered this trial. Complete remission rate was 90.5%, with a 100% overall response rate (RR) at the end of induction therapy; overall survival (OS) rate at 3 years was 76.4% (median follow-up 744 days), with an 82.6% 3-year progression-free survival (PFS) rate (median follow-up 744 days). The most common grade 3/4 toxicities were hematologic, including neutropenia in 75.0% of the patients despite prophylactic administration of granulocyte colony-stimulating factor (G-CSF), febrile neutropenia in 30.0%, respectively. There was no treatment-related mortality (TRM). Rituximab not only combined with chemotherapy but also given sequentially improved survival. R-VNCOP-B could be another option for elderly patients who are not considered to tolerate in receiving R-CHOP.
CHOP（环磷酰胺、阿霉素、长春新碱和泼尼松）加利妥昔单抗是一种标准的化疗方案，用于治疗侵袭性 B 细胞非霍奇金淋巴瘤（B-NHL）患者。然而，在老年患者中，该方案在疗效和安全性方面并不完全令人满意。我们报告了在 8 个协作机构的临床经验，以确定 VNCOP-B（依托泊苷、米托蒽醌、环磷酰胺、长春新碱、泼尼松和博来霉素）联合利妥昔单抗治疗侵袭性 B-NHL 老年患者是否有效和安全。2004 年 9 月至 2007 年 12 月，23 例未经治疗的患者入组，中位年龄 73 岁，50.0%按标准国际预后指数（IPI）分类为中高危，入组本试验。诱导治疗结束时完全缓解率为 90.5%，总缓解率（RR）为 100%；3 年总生存率（OS）为 76.4%（中位随访 744 天），3 年无进展生存率（PFS）为 82.6%（中位随访 744 天）。最常见的 3/4 级血液学毒性包括中性粒细胞减少，尽管预防性给予粒细胞集落刺激因子（G-CSF），仍有 75.0%的患者发生，分别有 30.0%的患者发生发热性中性粒细胞减少。无治疗相关死亡（TRM）。利妥昔单抗不仅与化疗联合，而且序贯给药可改善生存。R-VNCOP-B 可能是那些不能耐受 R-CHOP 治疗的老年患者的另一种选择。
