Treatment of indolent B-cell nonfollicular lymphomas: Final results of the LL01 randomized trial of the Gruppo Italiano per lo Studio dei Linfomi

Luca Baldini, Maura Brugiatelli, Stefano Luminari, Marco Lombardo, Francesco Merli, Stefano Sacchi, Paolo Gobbi, Marina Liberati, Luigi Cavanna, Mariangela Colombi, Caterina Stelitano, Maria Goldaniga, Fortunato Morabito, Massimo Federico, Vittorio Silingardi

Research output: Contribution to journalArticle

Abstract

Purpose: To evaluate the effect of epirubicin on therapeutic response and survival in patients with indolent non-follicular B-cell lymphomas (INFL) treated with pulsed high-dose chlorambucil. Patients and Methods: A total of 170 untreated patients with advanced/active INFL were randomly assigned to receive either eight cycles of high-dose chlorambucil (15 mg/m2/d) plus prednisone (100 mg/d) for 5 days (HD-CHL-P; arm A) or eight cycles of HD-CHL-P plus epirubicin 60 mg/m2 intravenous on day 1 (arm B). The responding patients were randomly assigned to either maintenance therapy with interferon alfa (IFNα-2a; 3 MU, three times weekly) for 12 months or observation. Results: There were 160 assessable patients (82 males, 78 females; median age, 63 years; range, 33 to 77 years); 77 patients were assigned to arm A, and 83 were assigned to arm B. Induction therapy led to 47 complete responses (CRs; 29.4%) and 68 partial responses (PRs; 42.5%), with no significant difference between the two arms (60 CR + PR in arm A [77.9%] and 55 CR + PR in arm B [66.3%]; P = .07). After a median follow-up of 38 months (range, 2 to 103 months), there was no between-group difference in overall survival (OS; P = .45), failure-free survival (P = .07), or progression-free survival (PFS; P = .5). Eighty-eight patients were randomly assigned to either IFNα-2a (n = 43) or observation (n = 45), without any difference in 3-year PFS (44% and 42%, respectively). Univariate analysis showed that OS was influenced by age, anemia, serum lactate dehydrogenase levels, and International Prognostic Index distribution; multivariate analysis identified age and anemia as having influence on OS. Conclusion: HD-CHL-P treatment outcome in INFL patients was good (50% 3-year PFS, minimal toxicity, and low costs); epirubicin did not add any advantage. One-year IFNα maintenance treatment did not prolong response duration.

Original languageEnglish
Pages (from-to)1459-1465
Number of pages7
JournalJournal of Clinical Oncology
Volume21
Issue number8
DOIs
Publication statusPublished - Apr 15 2003

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B-Cell Lymphoma
Epirubicin
Chlorambucil
Therapeutics
Survival
Anemia
Observation
Prednisone
L-Lactate Dehydrogenase
Disease-Free Survival
Multivariate Analysis
Costs and Cost Analysis
Serum

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Treatment of indolent B-cell nonfollicular lymphomas : Final results of the LL01 randomized trial of the Gruppo Italiano per lo Studio dei Linfomi. / Baldini, Luca; Brugiatelli, Maura; Luminari, Stefano; Lombardo, Marco; Merli, Francesco; Sacchi, Stefano; Gobbi, Paolo; Liberati, Marina; Cavanna, Luigi; Colombi, Mariangela; Stelitano, Caterina; Goldaniga, Maria; Morabito, Fortunato; Federico, Massimo; Silingardi, Vittorio.

In: Journal of Clinical Oncology, Vol. 21, No. 8, 15.04.2003, p. 1459-1465.

Research output: Contribution to journalArticle

Baldini, L, Brugiatelli, M, Luminari, S, Lombardo, M, Merli, F, Sacchi, S, Gobbi, P, Liberati, M, Cavanna, L, Colombi, M, Stelitano, C, Goldaniga, M, Morabito, F, Federico, M & Silingardi, V 2003, 'Treatment of indolent B-cell nonfollicular lymphomas: Final results of the LL01 randomized trial of the Gruppo Italiano per lo Studio dei Linfomi', Journal of Clinical Oncology, vol. 21, no. 8, pp. 1459-1465. https://doi.org/10.1200/JCO.2003.07.133
Baldini, Luca ; Brugiatelli, Maura ; Luminari, Stefano ; Lombardo, Marco ; Merli, Francesco ; Sacchi, Stefano ; Gobbi, Paolo ; Liberati, Marina ; Cavanna, Luigi ; Colombi, Mariangela ; Stelitano, Caterina ; Goldaniga, Maria ; Morabito, Fortunato ; Federico, Massimo ; Silingardi, Vittorio. / Treatment of indolent B-cell nonfollicular lymphomas : Final results of the LL01 randomized trial of the Gruppo Italiano per lo Studio dei Linfomi. In: Journal of Clinical Oncology. 2003 ; Vol. 21, No. 8. pp. 1459-1465.
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abstract = "Purpose: To evaluate the effect of epirubicin on therapeutic response and survival in patients with indolent non-follicular B-cell lymphomas (INFL) treated with pulsed high-dose chlorambucil. Patients and Methods: A total of 170 untreated patients with advanced/active INFL were randomly assigned to receive either eight cycles of high-dose chlorambucil (15 mg/m2/d) plus prednisone (100 mg/d) for 5 days (HD-CHL-P; arm A) or eight cycles of HD-CHL-P plus epirubicin 60 mg/m2 intravenous on day 1 (arm B). The responding patients were randomly assigned to either maintenance therapy with interferon alfa (IFNα-2a; 3 MU, three times weekly) for 12 months or observation. Results: There were 160 assessable patients (82 males, 78 females; median age, 63 years; range, 33 to 77 years); 77 patients were assigned to arm A, and 83 were assigned to arm B. Induction therapy led to 47 complete responses (CRs; 29.4{\%}) and 68 partial responses (PRs; 42.5{\%}), with no significant difference between the two arms (60 CR + PR in arm A [77.9{\%}] and 55 CR + PR in arm B [66.3{\%}]; P = .07). After a median follow-up of 38 months (range, 2 to 103 months), there was no between-group difference in overall survival (OS; P = .45), failure-free survival (P = .07), or progression-free survival (PFS; P = .5). Eighty-eight patients were randomly assigned to either IFNα-2a (n = 43) or observation (n = 45), without any difference in 3-year PFS (44{\%} and 42{\%}, respectively). Univariate analysis showed that OS was influenced by age, anemia, serum lactate dehydrogenase levels, and International Prognostic Index distribution; multivariate analysis identified age and anemia as having influence on OS. Conclusion: HD-CHL-P treatment outcome in INFL patients was good (50{\%} 3-year PFS, minimal toxicity, and low costs); epirubicin did not add any advantage. One-year IFNα maintenance treatment did not prolong response duration.",
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T1 - Treatment of indolent B-cell nonfollicular lymphomas

T2 - Final results of the LL01 randomized trial of the Gruppo Italiano per lo Studio dei Linfomi

AU - Baldini, Luca

AU - Brugiatelli, Maura

AU - Luminari, Stefano

AU - Lombardo, Marco

AU - Merli, Francesco

AU - Sacchi, Stefano

AU - Gobbi, Paolo

AU - Liberati, Marina

AU - Cavanna, Luigi

AU - Colombi, Mariangela

AU - Stelitano, Caterina

AU - Goldaniga, Maria

AU - Morabito, Fortunato

AU - Federico, Massimo

AU - Silingardi, Vittorio

PY - 2003/4/15

Y1 - 2003/4/15

N2 - Purpose: To evaluate the effect of epirubicin on therapeutic response and survival in patients with indolent non-follicular B-cell lymphomas (INFL) treated with pulsed high-dose chlorambucil. Patients and Methods: A total of 170 untreated patients with advanced/active INFL were randomly assigned to receive either eight cycles of high-dose chlorambucil (15 mg/m2/d) plus prednisone (100 mg/d) for 5 days (HD-CHL-P; arm A) or eight cycles of HD-CHL-P plus epirubicin 60 mg/m2 intravenous on day 1 (arm B). The responding patients were randomly assigned to either maintenance therapy with interferon alfa (IFNα-2a; 3 MU, three times weekly) for 12 months or observation. Results: There were 160 assessable patients (82 males, 78 females; median age, 63 years; range, 33 to 77 years); 77 patients were assigned to arm A, and 83 were assigned to arm B. Induction therapy led to 47 complete responses (CRs; 29.4%) and 68 partial responses (PRs; 42.5%), with no significant difference between the two arms (60 CR + PR in arm A [77.9%] and 55 CR + PR in arm B [66.3%]; P = .07). After a median follow-up of 38 months (range, 2 to 103 months), there was no between-group difference in overall survival (OS; P = .45), failure-free survival (P = .07), or progression-free survival (PFS; P = .5). Eighty-eight patients were randomly assigned to either IFNα-2a (n = 43) or observation (n = 45), without any difference in 3-year PFS (44% and 42%, respectively). Univariate analysis showed that OS was influenced by age, anemia, serum lactate dehydrogenase levels, and International Prognostic Index distribution; multivariate analysis identified age and anemia as having influence on OS. Conclusion: HD-CHL-P treatment outcome in INFL patients was good (50% 3-year PFS, minimal toxicity, and low costs); epirubicin did not add any advantage. One-year IFNα maintenance treatment did not prolong response duration.

AB - Purpose: To evaluate the effect of epirubicin on therapeutic response and survival in patients with indolent non-follicular B-cell lymphomas (INFL) treated with pulsed high-dose chlorambucil. Patients and Methods: A total of 170 untreated patients with advanced/active INFL were randomly assigned to receive either eight cycles of high-dose chlorambucil (15 mg/m2/d) plus prednisone (100 mg/d) for 5 days (HD-CHL-P; arm A) or eight cycles of HD-CHL-P plus epirubicin 60 mg/m2 intravenous on day 1 (arm B). The responding patients were randomly assigned to either maintenance therapy with interferon alfa (IFNα-2a; 3 MU, three times weekly) for 12 months or observation. Results: There were 160 assessable patients (82 males, 78 females; median age, 63 years; range, 33 to 77 years); 77 patients were assigned to arm A, and 83 were assigned to arm B. Induction therapy led to 47 complete responses (CRs; 29.4%) and 68 partial responses (PRs; 42.5%), with no significant difference between the two arms (60 CR + PR in arm A [77.9%] and 55 CR + PR in arm B [66.3%]; P = .07). After a median follow-up of 38 months (range, 2 to 103 months), there was no between-group difference in overall survival (OS; P = .45), failure-free survival (P = .07), or progression-free survival (PFS; P = .5). Eighty-eight patients were randomly assigned to either IFNα-2a (n = 43) or observation (n = 45), without any difference in 3-year PFS (44% and 42%, respectively). Univariate analysis showed that OS was influenced by age, anemia, serum lactate dehydrogenase levels, and International Prognostic Index distribution; multivariate analysis identified age and anemia as having influence on OS. Conclusion: HD-CHL-P treatment outcome in INFL patients was good (50% 3-year PFS, minimal toxicity, and low costs); epirubicin did not add any advantage. One-year IFNα maintenance treatment did not prolong response duration.

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