Kikuchi Misato, Nakasone Hideki, Akahoshi Yu, Nakano Hirofumi, Ugai Tomotaka, Wada Hidenori, Yamasaki Ryoko, Sakamoto Kana, Kawamura Koji, Ishihara Yuko, Sato Miki, Ashizawa Masahiro, Terasako-Saito Kiriko, Kimura Shun-ichi, Yamazaki Rie, Kako Shinichi, Kanda Junya, Nishida Junji, Sekiguchi Naohiro, Noto Satoshi, Kida Michiko, Hangaishi Akira, Usuki Kensuke, Kanda Yoshinobu
J Chemother. 2015 Feb;27(2):99-105. doi: 10.1179/1973947814Y.0000000219. Epub 2014 Oct 14.
Elderly patients with non-Hodgkin lymphoma (NHL) have a poor prognosis. Owing to treatment-related toxicities, there is no standard chemotherapy for the elderly patients, especially those aged 70 years or older. In this study, we retrospectively evaluated the efficacy and toxicity of reduced-dose (two-thirds) R-CHOP chemotherapy as an initial chemotherapy for 45 patients aged 70 years or older with B-cell NHL. The WHO classification of NHL included diffuse large B-cell lymphoma (DLBCL) (31), mantle cell lymphoma (5), follicular lymphoma (4), extranodal marginal zone lymphoma (1), Burkitt lymphoma (1), and B-cell lymphoma whose further types were unclassified (3). The incidences of grade 4 neutropenia and febrile neutropenia (FN) were 51.1 and 15.6%, respectively. Efficacy was evaluated in patients with DLBCL. The overall and complete response (CR) rates were 96.7 and 90.0%, respectively. Two-year event-free survival (EFS) and overall survival (OS) were 84.4 and 89.2%, respectively. There was no treatment-related mortality. In conclusion, two-thirds R-CHOP chemotherapy is a promising treatment for elderly patients with B-cell NHL in terms of its efficacy and toxicity.
老年非霍奇金淋巴瘤（NHL）患者预后较差。由于治疗相关毒性，老年患者，尤其是70岁及以上的患者，没有标准的化疗方案。在本研究中，我们回顾性评估了低剂量（三分之二）R-CHOP化疗作为45例70岁及以上B细胞NHL患者初始化疗的疗效和毒性。NHL的世界卫生组织分类包括弥漫性大B细胞淋巴瘤（DLBCL）（31例）、套细胞淋巴瘤（5例）、滤泡性淋巴瘤（4例）、结外边缘区淋巴瘤（1例）、伯基特淋巴瘤（1例）以及进一步类型未分类的B细胞淋巴瘤（3例）。4级中性粒细胞减少症和发热性中性粒细胞减少症（FN）的发生率分别为51.1%和15.6%。对DLBCL患者进行了疗效评估。总缓解率和完全缓解（CR）率分别为96.7%和90.0%。两年无事件生存期（EFS）和总生存期（OS）分别为84.4%和89.2%。无治疗相关死亡。总之，就疗效和毒性而言，三分之二剂量的R-CHOP化疗是老年B细胞NHL患者一种有前景的治疗方法。
