Annals of Oncology Advance Access published online on February 25, 2008
Annals of Oncology, doi:10.1093/annonc/mdm560
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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.
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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