Treatment outcomes of dose-attenuated CHOP chemotherapy in elderly patients with peripheral T cell lymphoma.
- Author:
Eun Ji CHOI
1
;
Jung Yong HONG
;
Dok Hyun YOON
;
Jihoon KANG
;
Chan Sik PARK
;
Jooryung HUH
;
Eun Jin CHAE
;
Yoonse LEE
;
Jin Sook RYU
;
Cheolwon SUH
Author Information
- Publication Type:Original Article
- Keywords: Peripheral T cell lymphoma; Elderly; Dose-attenuated CHOP
- MeSH: Aged*; Comorbidity; Cyclophosphamide; Doxorubicin; Drug Therapy*; Febrile Neutropenia; Follow-Up Studies; Humans; L-Lactate Dehydrogenase; Lymphoma, T-Cell, Peripheral*; Neutropenia; Prednisolone; Survival Rate; Thrombocytopenia; Treatment Outcome; Vincristine
- From:Blood Research 2017;52(4):270-275
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: While cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is the most commonly used chemotherapeutic regimen for patients with peripheral T-cell lymphomas (PTCLs), elderly patients are more vulnerable to associated toxicities. We evaluated the efficacy and safety of dose-attenuated CHOP in elderly patients with PTCL. METHODS: Patients with PTCL aged >70 years or 65–70-years with comorbidities were treated with dose-attenuated CHOP (cyclophosphamide: 562.5 mg/m2, doxorubicin: 37.5 mg/m2, vincristine: 1.4 mg/m2, and prednisolone: 100 mg for five days; 25% reduced dose of cyclophosphamide and doxorubicin vs. full-dose CHOP) as first-line therapy were included. RESULTS: Forty-four patients (median age, 74 yr) were analyzed. The majority (N=42, 95.5%) had advanced stage disease and 36 (81.8%) were classified as high/high-intermediate risk by the international prognostic index. The overall response rate was 61.4%, and 21 patients achieved complete response (47.7%). With median follow-up period of 28.8 months, the estimated two-year progression-free and overall survival rates were 36.7% and 46.6%, respectively. Grade 3/4 neutropenia and thrombocytopenia occurred in 26.9% and 7.4% of 204 total cycles, which affected 76.7% and 25.6% of the patients, respectively. Nineteen patients (44.2%) experienced febrile neutropenia, and six died due to treatment-related toxicities. High lactate dehydrogenase levels and an involvement of >1 extranodal sites were prognostic indicators of poor survival. CONCLUSION: Dose-attenuated CHOP does not compromise treatment efficacy but retains significant toxicity. Our results suggest that some patients can be effectively treated with dose-attenuated CHOP, however a novel therapy for elderly patients with PTCL is required.
