Biweekly rituximab, cyclophosphamide, vincristine, non-pegylated liposome-encapsulated doxorubicin and prednisone (R-COMP-14) in elderly patients with poor-risk diffuse large B-cell lymphoma and moderate to high 'life threat' impact cardiopathy

Gaetano Corazzelli, Ferdinando Frigeri, Manuela Arcamone, Anna Lucania, Maria Rosariavilla, Emanuela Morelli, Alfonso Amore, Gaetana Capobianco, Antonietta Caronna, Cristina Becchimanzi, Francesco Volzone, Gianpaolo Marcacci, Filippo Russo, Rosaria de Filippi, Lucia Mastrullo, Antonio Pinto

Research output: Contribution to journalArticlepeer-review

Abstract

This Phase II study assessed feasibility and efficacy of a biweekly R-COMP-14 regimen (rituximab, cyclophosphamide, non-pegylated liposome-encapsulated doxorubicin, vincristine and prednisone) in untreated elderly patients with poor-risk diffuse large B-cell lymphoma (DLBCL) and moderate to high 'life threat' impact NIA/NCI cardiac comorbidity. A total of 208 courses were delivered, with close cardiac monitoring, to 41 patients (median age: 73years, range: 62-82; 37% >75years) at a median interval of 15.6 (range, 13-29) days; 67% completed all six scheduled courses. Response rate was 73%, with 68% complete responses (CR); 4-year disease-free survival (DFS) and time to treatment failure (TTF) were 72% and 49%, respectively. Failures were due to early death (n=3), therapy discontinuations (no-response n=2; toxicity n=6), relapse (n=6) and death in CR (n=3). Incidence of cardiac grade 3-5 adverse events was 7/41 (17%; 95% confidence interval: 8-31%). Time to progression and overall survival at 4-years were 77% and 67%, respectively. The Age-adjusted Charlson Comorbidity Index (aaCCI) correlated with failures (P=0.007) with patients scoring ≤7 having a longer TTF (66% vs. 29%; P=0.009). R-COMP-14 is feasible and ensures a substantial DFS to poor-risk DLBCL patients who would have been denied anthracycline-based treatment due to cardiac morbidity. The aaCCI predicted both treatment discontinuation rate and TTF.

Original languageEnglish
Pages (from-to)579-589
Number of pages11
JournalBritish Journal of Haematology
Volume154
Issue number5
DOIs
Publication statusPublished - Sep 2011

Keywords

  • Cardiotoxicity
  • Charlson Comorbidity Index
  • Diffuse large B-cell lymphoma
  • Elderly
  • Non-pegylated liposomal doxorubicin

ASJC Scopus subject areas

  • Hematology

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