Yazarlar : Räty R, Honkanen T, Jantunen E, et al.

Yayın : Leuk Lymphoma.

Yayın Yılı : 2012

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/22397313

Konu : Geriyatrik Hematoloji

Literatür İçeriği :  

Abstract

Abstract There is no consensus of treatment strategies for elderly patients with mantle cell lymphoma (MCL). In this prospective phase II study we investigated whether the poor outcome could be improved with reasonable toxicity by prolonging the immunochemotherapy. Ten cycles of alternating CHOP/AraC with eight doses of rituximab were given as induction. The potential synergism of intermediate-dose AraC and fludarabine was tested in cycles 6-8. Induction was followed by bimonthly rituximab maintenance for two years. The median age of the 60 included patients was 74 years, and the MIPI index was intermediate or high risk in 98% of the patients. The overall response rate was 95% (CR/CRu 87%). The response of 11 patients improved with cycles 6-8 (R-fludarabine-AraC). Progression-free survival was 70% and overall survival 72% at four years, respectively. Treatment related mortality was 2%. Severe infections were rare with only one grade 4 infection. More dose reductions were needed during fludarabine-containg courses as compared to R-AraC. In 20 patients a transient grade 4 neutropenia without severe infections was recorded during maintenance. In conclusion, elderly patients with MCL can be treated relatively intensively with acceptable toxicity.

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