A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients

P. L. Zinzani, M. Tani, S. Fanti, V. Stefoni, G. Musuraca, P. Castellucci, E. Marchi, M. Farsad, M. Fina, C. Pellegrini, L. Alinari, E. Derenzini, A. de Vivo, F. Bacci, S. Pileri, M. Baccarani

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)769-773
Number of pages5
JournalAnnals of Oncology
Volume19
Issue number4
DOIs
Publication statusPublished - Apr 2008

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Lymphoma, Large B-Cell, Diffuse
Drug Therapy
Radioimmunotherapy
ibritumomab tiuxetan
Poisons
Vincristine
Prednisone
Combination Drug Therapy
Neutropenia
Thrombocytopenia
Doxorubicin
Cyclophosphamide
Disease-Free Survival
Blood Platelets
Safety
Survival

Keywords

  • Chemotherapy
  • DLBCL
  • Elderly patients
  • Yttrium 90 ibritumomab tiuxetan

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients. / Zinzani, P. L.; Tani, M.; Fanti, S.; Stefoni, V.; Musuraca, G.; Castellucci, P.; Marchi, E.; Farsad, M.; Fina, M.; Pellegrini, C.; Alinari, L.; Derenzini, E.; de Vivo, A.; Bacci, F.; Pileri, S.; Baccarani, M.

In: Annals of Oncology, Vol. 19, No. 4, 04.2008, p. 769-773.

Research output: Contribution to journalArticle

Zinzani, PL, Tani, M, Fanti, S, Stefoni, V, Musuraca, G, Castellucci, P, Marchi, E, Farsad, M, Fina, M, Pellegrini, C, Alinari, L, Derenzini, E, de Vivo, A, Bacci, F, Pileri, S & Baccarani, M 2008, 'A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients', Annals of Oncology, vol. 19, no. 4, pp. 769-773. https://doi.org/10.1093/annonc/mdm560
Zinzani, P. L. ; Tani, M. ; Fanti, S. ; Stefoni, V. ; Musuraca, G. ; Castellucci, P. ; Marchi, E. ; Farsad, M. ; Fina, M. ; Pellegrini, C. ; Alinari, L. ; Derenzini, E. ; de Vivo, A. ; Bacci, F. ; Pileri, S. ; Baccarani, M. / A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients. In: Annals of Oncology. 2008 ; Vol. 19, No. 4. pp. 769-773.
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abstract = "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.",
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T1 - A phase II trial of CHOP chemotherapy followed by yttrium 90 ibritumomab tiuxetan (Zevalin) for previously untreated elderly diffuse large B-cell lymphoma patients

AU - Zinzani, P. L.

AU - Tani, M.

AU - Fanti, S.

AU - Stefoni, V.

AU - Musuraca, G.

AU - Castellucci, P.

AU - Marchi, E.

AU - Farsad, M.

AU - Fina, M.

AU - Pellegrini, C.

AU - Alinari, L.

AU - Derenzini, E.

AU - de Vivo, A.

AU - Bacci, F.

AU - Pileri, S.

AU - Baccarani, M.

PY - 2008/4

Y1 - 2008/4

N2 - 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.

AB - 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.

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KW - Elderly patients

KW - Yttrium 90 ibritumomab tiuxetan

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