Annals of Oncology Advance Access originally published online on February 25, 2008
Annals of Oncology 2008 19(4):769-773; doi:10.1093/annonc/mdm560
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hematologic malignancies |
A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients
1 Institute of Hematology and Medical Oncology ‘L. & A. Seràgnoli’, University of Bologna, Bologna
2 Department of Nuclear Medicine, S.Orsola-Malpighi Hospital, Bologna, Italy
* Correspondence to: Dr P. L. Zinzani, Institute of Hematology and Oncology ‘L. & A. Seràgnoli’, University of Bologna, via Massarenti 9, 40138 Bologna, Italy. Tel: +39-051-6363680; Fax: +39-051-6364037; E-mail: plzinzo{at}med.unibo.it
Background: A prospective, single-arm, open-label, nonrandomized phase II combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) plus radioimmunotherapy trial was conducted to evaluate the efficacy and safety in untreated elderly diffuse large B-cell lymphoma (DLBCL) patients.
Patients and methods: From February 2005 to April 2006, in our institute we treated 20 eligible elderly (age 
60 years) patients with previously untreated DLBCL using a novel regimen consisting of six cycles of CHOP chemotherapy followed 6–10 weeks later by 90Y ibritumomab tiuxetan.
Results: The overall response rate to the entire treatment regimen was 100%, including 95% complete remission (CR) and 5% partial remission. Four (80%) of the five patients who achieved less than a CR with CHOP improved their remission status after radioimmunotherapy. With a median follow-up of 15 months, the 2-year progression-free survival was estimated to be 75%, with a 2-year overall survival of 95%. The 90Y ibritumomab tiuxetan toxicity included grade 3 hematologic toxicity in 12 of 20 patients; the most common grade 3 toxic effects were neutropenia (12 patients) and thrombocytopenia (7 patients). Transfusions of red blood cells and/or platelets were given to one patient.
Conclusion: This study has established the feasibility, tolerability, and efficacy of this regimen for elderly patients with DLBCL.
Key words: Chemotherapy, DLBCL, elderly patients, yttrium 90 ibritumomab tiuxetan
Received for publication April 30, 2007. Revision received July 25, 2007. Revision received September 13, 2007. Accepted for publication November 12, 2007.
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