ACOD, a modified CHOP regimen for elderly patients with aggressive non-Hodgkin's lymphoma

P. Santoro, Giovanni Martinelli, P. F. Ferrucci, W. Mingrone, E. Cocorocchio, A. Conconi, F. A. Peccatori, K. De Luzio, C. Mazzetta, E. Zucca, F. Cavalli

Research output: Contribution to journalArticlepeer-review


The aim of this study is to verify the feasibility and the clinical activity of a new CHOP-like schedule (ACOD) with a fractionated days 1 and 8 administration in elderly patients. This regimen was chosen in the attempt to allow a sufficient dose intensity (DI) of each drug with better compliance. Fifty-two patients, (74 years, median age), with diffuse large B cell non-Hodgkin's lymphoma were retrospectively evaluated. Patients received ADM 25 mg/sqm, CTX 500 mg/sqm, VCR 1.2 mg/sqm (max 2 mg intravenously) days 1 and 8 and PDN 50 mg orally, days 1-8. Results showed that 54% of patients reached a complete remission, 21% a partial remission with an overall response rate of 75%. Two-thirds of the patients received at least 70% of the planned dose of cyclophosphamide and doxorubicin and 50% of vincristine and prednisone. The median duration of follow up was 12.6 months (range 0.7-61.4). The estimated median OS was 15.2 months (95%CI = [11.6, not estimable]); the estimated median PFS was 5.7 months (95%CI = [5.12, not estimable]). After 2 years, the proportion of patients alive was 47% (95%CI = 34-64%) and the proportion of patients free from progression was 39% (95%CI = 27-57%). Grade 3-4 leukopenia was observed in 61% of patients with 11% of febrile neutropenia. In conclusion, the ACOD chemotherapy regimen seems safe and feasible in elderly patients. This schedule allowed a sufficient DI of chemotherapic agents with clinical results very similar to those recorded with the standard CHOP regimen in young adults.

Original languageEnglish
Pages (from-to)801-806
Number of pages6
JournalLeukemia and Lymphoma
Issue number5
Publication statusPublished - May 1 2003


  • Adriamycin
  • CHOP
  • Elderly patients
  • Non-Hodgkin's lymphoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research


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