Abstract
We conducted a prospective study to compare epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab (R-miniCEOP) with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab (R-CHOP) for the treatment of "fit" elderly patients with diffuse large B-cell lymphoma (DLBCL). Patients over the age of 65 with stage II-IV DLBCL were screened with a comprehensive geriatric assessment. Patients were randomized to receive six courses of R-miniCEOP (n = 114) or R-CHOP (n = 110). Overall, the rate of complete remission was 70% (p = 0.466). After a median follow-up of 42 months, 5-year event-free survival (EFS) rates were 46% and 48% for R-miniCEOP and R-CHOP, respectively (p = 0.538). Patients older than 72 years and with low-risk disease had a better outcome when treated with R-miniCEOP (p = 0.011). Overall R-CHOP and R-miniCEOP are similarly effective for elderly "fit" patients with DLBCL. The less intense R-miniCEOP may be an acceptable option for the treatment of relatively older patients with low-risk disease.
Trial registration:
ClinicalTrials.gov NCT01148446.
Publication types
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Randomized Controlled Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Aged, 80 and over
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Anemia / chemically induced
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Antibodies, Monoclonal, Murine-Derived / administration & dosage
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Antibodies, Monoclonal, Murine-Derived / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Disease-Free Survival
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Epirubicin / administration & dosage
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Epirubicin / adverse effects
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Female
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Follow-Up Studies
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Geriatric Assessment / methods
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Geriatric Assessment / statistics & numerical data
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Humans
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Kaplan-Meier Estimate
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Lymphoma, Large B-Cell, Diffuse / drug therapy*
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Lymphoma, Large B-Cell, Diffuse / pathology
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Male
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Middle Aged
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Multivariate Analysis
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Neutropenia / chemically induced
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Proportional Hazards Models
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Prospective Studies
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Rituximab
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Treatment Outcome
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Vincristine / administration & dosage
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Vincristine / adverse effects
Substances
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Antibodies, Monoclonal, Murine-Derived
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Epirubicin
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisone
Associated data
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ClinicalTrials.gov/NCT01148446