Efficacy and toxicity of liposomal daunorubicin included in PVABEC regimen for aggressive NHL of the elderly

Leuk Lymphoma. 2003 Mar;44(3):465-9. doi: 10.1080/1042819021000037921.

Abstract

Liposomes used for delivering antineoplastic drugs to sites of disease are able to minimize side effects and enhance therapeutic efficacy. Liposomal Daunorubicin (Daunoxome; DNX) has a selective and higher accumulation in neoplastic tissues and seems to be able to escape Multi-Drug Resistance (MDR). We treated 35 elderly patients with aggressive non-Hodgkin's lymphoma (NHL) with PVBECDNX, a regimen analogue to P-VABEC in which doxorubicin is replaced with DNX at a dose of 50 mg (first 13 patients) and thereafter 50 mg/m2. Twenty-six out of 35 patients were evaluable for response; 15 obtained a CR, 5 a PR (overall response rate of 77%). After a median follow-up of 13 months the 2-years actuarial overall survival was 75% and the failure-free survival was 71%. Two patients out of six no responders died because of progression of disease, and one died in CR because of pre-existing cardiovascular disorders. Eight patients did not tolerate DNX infusion (back pain). Non-haematological toxicity was mild. This study confirms that PVABEC-like regimens are able to induce a high overall response rate in a percentage of patients affected by aggressive lymphoma and shows that DNX is as effective as Daunorubicin in these disorders, but its acute toxicity is reduced.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Daunorubicin / administration & dosage
  • Daunorubicin / adverse effects
  • Disease Progression
  • Disease-Free Survival
  • Drug Carriers
  • Female
  • Follow-Up Studies
  • Humans
  • Liposomes
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / mortality
  • Male
  • Middle Aged
  • Neutropenia / chemically induced
  • Pain / chemically induced
  • Remission Induction
  • Survival Analysis
  • Survival Rate
  • Thrombocytopenia / chemically induced
  • Treatment Outcome

Substances

  • Drug Carriers
  • Liposomes
  • Daunorubicin