A prospective study of a new combination chemotherapy regimen in patients older than 70 years with unfavorable non-Hodgkin's lymphoma

U. Tirelli, V. Zagonel, D. Errante, D. Serraino, R. Talamini, M. De Cicco, A. Carbone, S. Monfardini

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Abstract

Purpose: A prospective trial with a new combination of etoposide, mitoxantrone, and prednimustine (VMP), specifically devised for elderly patients with non-Hodgkin's lymphoma (NHL), was undertaken. Patients and Methods: Between January 1987 and April 1990, 52 consecutive unselected patients older than 70 years (median age, 75.6 years) with stage I to IV intermediate- and high-grade NHL, or with stage III to IV low-grade malignancy with symptomatic disease received etoposide and prednimustine 80 mg/m2 orally for 5 days and mitoxantrone 8 to 10 mg/m2 day 1 intravenously (IV), every 21 days. Fourteen patients were previously treated. Results: Among the 48 assessable patients, the objective response rate was 81%; 46% of the patients achieved a complete response (CR). The overall toxicity seemed to be acceptable, with 15 (7%) episodes of grade 4 leukope-nia and 41 (18%) episodes of grade 3, over a total of 226 administered cycles. The median survival was 12 months. The patients who obtained CR have a longer survival than those who did not (34 v 8 months; P <.001). Fifty-eight percent of patients achieving CR were free from relapse at 24 months; up to 36 months from the start of therapy, 25% were free from relapse. As far as patients affected by diffuse histiocytic lymphoma, 66% of previously untreated patients obtained a CR, and 55% of them were still disease-free at 24 months from the start of therapy. Conclusion: We conclude that VMP is effective, well tolerated, and feasible on an outpatient basis in an unselected, elderly population affected by unfavorable NHL.

Original languageEnglish
Pages (from-to)228-236
Number of pages9
JournalJournal of Clinical Oncology
Volume10
Issue number2
Publication statusPublished - 1992

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Combination Drug Therapy
Non-Hodgkin's Lymphoma
Prospective Studies
Prednimustine
Mitoxantrone
Etoposide
Recurrence
Survival
Lymphoma, Large B-Cell, Diffuse
Outpatients
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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A prospective study of a new combination chemotherapy regimen in patients older than 70 years with unfavorable non-Hodgkin's lymphoma. / Tirelli, U.; Zagonel, V.; Errante, D.; Serraino, D.; Talamini, R.; De Cicco, M.; Carbone, A.; Monfardini, S.

In: Journal of Clinical Oncology, Vol. 10, No. 2, 1992, p. 228-236.

Research output: Contribution to journalArticle

Tirelli, U. ; Zagonel, V. ; Errante, D. ; Serraino, D. ; Talamini, R. ; De Cicco, M. ; Carbone, A. ; Monfardini, S. / A prospective study of a new combination chemotherapy regimen in patients older than 70 years with unfavorable non-Hodgkin's lymphoma. In: Journal of Clinical Oncology. 1992 ; Vol. 10, No. 2. pp. 228-236.
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AU - Tirelli, U.

AU - Zagonel, V.

AU - Errante, D.

AU - Serraino, D.

AU - Talamini, R.

AU - De Cicco, M.

AU - Carbone, A.

AU - Monfardini, S.

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N2 - Purpose: A prospective trial with a new combination of etoposide, mitoxantrone, and prednimustine (VMP), specifically devised for elderly patients with non-Hodgkin's lymphoma (NHL), was undertaken. Patients and Methods: Between January 1987 and April 1990, 52 consecutive unselected patients older than 70 years (median age, 75.6 years) with stage I to IV intermediate- and high-grade NHL, or with stage III to IV low-grade malignancy with symptomatic disease received etoposide and prednimustine 80 mg/m2 orally for 5 days and mitoxantrone 8 to 10 mg/m2 day 1 intravenously (IV), every 21 days. Fourteen patients were previously treated. Results: Among the 48 assessable patients, the objective response rate was 81%; 46% of the patients achieved a complete response (CR). The overall toxicity seemed to be acceptable, with 15 (7%) episodes of grade 4 leukope-nia and 41 (18%) episodes of grade 3, over a total of 226 administered cycles. The median survival was 12 months. The patients who obtained CR have a longer survival than those who did not (34 v 8 months; P <.001). Fifty-eight percent of patients achieving CR were free from relapse at 24 months; up to 36 months from the start of therapy, 25% were free from relapse. As far as patients affected by diffuse histiocytic lymphoma, 66% of previously untreated patients obtained a CR, and 55% of them were still disease-free at 24 months from the start of therapy. Conclusion: We conclude that VMP is effective, well tolerated, and feasible on an outpatient basis in an unselected, elderly population affected by unfavorable NHL.

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