Abstract
Clinical and/or biological risk factors are needed to identify elderly patients with aggressive B-cell lymphoma able to receive full-dose R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) treatment. We present a retrospective analysis of 83 patients≥75 years of age (range: 75-97) who were diagnosed with aggressive B cell lymphoma between 2004 and 2011 in our clinic. R-CHOP-like therapy was administered in 82% of these patients resulting in a median overall survival of 54 months. A median cumulative dose of 226 mg/m2 doxorubicin and a median of six cycles were applied in these patients. Two genotypes of the CBR3 and MLH1 genes affecting the metabolism of cytostatics identified a subgroup with a favorable prognosis (median overall survival not reached vs. 30 months, p=0.01). A treatment strategy aiming at full-dose R-CHOP was feasible and resulted in an encouraging treatment outcome in patients≥75 years. Pharmacogenetic parameters, if independently validated, may be helpful in elderly patients.
Keywords:
Aggressive lymphoma; R-CHOP; elderly; single nucleotide polymorphisms; toxicity.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adaptor Proteins, Signal Transducing / genetics
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Aged
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Aged, 80 and over
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Alcohol Oxidoreductases / genetics
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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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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Drug Administration Schedule
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Female
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Genotype
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Humans
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Leukopenia / chemically induced
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Lymphoma, B-Cell / drug therapy*
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Lymphoma, B-Cell / genetics*
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Lymphoma, B-Cell / pathology
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Male
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MutL Protein Homolog 1
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Nuclear Proteins / genetics
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Polymorphism, Single Nucleotide*
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Prognosis
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Retrospective Studies
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Rituximab / administration & dosage
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Survival Analysis
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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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Adaptor Proteins, Signal Transducing
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MLH1 protein, human
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Nuclear Proteins
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Alcohol Oxidoreductases
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CBR3 protein, human
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MutL Protein Homolog 1
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Prednisone