Nonpeghylated liposomal doxorubicin combination regimen (R-COMP) for the treatment of lymphoma patients with advanced age or cardiac comorbidity.
Adult
Age Factors
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Comorbidity
Cyclophosphamide
/ administration & dosage
Doxorubicin
/ administration & dosage
Female
Follow-Up Studies
Heart Diseases
/ physiopathology
Humans
Italy
/ epidemiology
Lymphoma, Large B-Cell, Diffuse
/ drug therapy
Male
Middle Aged
Polyethylene Glycols
/ administration & dosage
Prognosis
Retrospective Studies
Rituximab
/ administration & dosage
Survival Rate
Vincristine
/ administration & dosage
advanced age
cardiopathy
cardiotoxicity
chemotherapy
liposomal doxorubicin
lymphoma
Journal
Hematological oncology
ISSN: 1099-1069
Titre abrégé: Hematol Oncol
Pays: England
ID NLM: 8307268
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
12
03
2020
revised:
06
06
2020
accepted:
09
06
2020
pubmed:
17
6
2020
medline:
3
11
2020
entrez:
17
6
2020
Statut:
ppublish
Résumé
Doxorubicin is the most effective single agent in the treatment of non-Hodgkin's lymphoma (NHL). Its use is limited because of the cardiac toxicity primarily in elderly patients (pts) and in pts with history of cardiac disease. Liposomal doxorubicin has been proven to reduce cardiotoxicity. The aim of this retrospective study was the use of nonpeghylated liposomal doxorubicin (NPLD) in term of efficacy, response rate and incidence of cardiac events. We retrospectively collected the experience of 33 Hematological Italian Centers in using NPLD. Nine hundred and forty-six consecutive pts treated with R-COMP (doxorubicin was substituted with NPLD, Myocet) were collected. Median age was 74 years, the reasons for use of NPLD were: age (466 pts), cardiac disease (298 pts), uncontrolled hypertension (126 pts), other reasons (56 pts). According to clinicians' evaluation, 49.9% of pts would not have used standard doxorubicin for different situations (age, cardiomyopathy, previous use of doxorubicin, and uncontrolled hypertension). Overall 687 pts (72.6%) obtained a complete remission (CR). About 5% (n = 51) of subjects developed major cardiotoxic events including heart failure (N = 31), ischemic heart disease (N = 16), acute heart attack (N = 3), and acute pulmonary oedema (N = 1). After a median follow-up of 32 months, 651 pts were alive and the overall survival (OS) was 72%. After a median observation period of 23 months disease free survival (DFS) was 58%. Either in univariate or in multivariate analysis OS and DFS were not significantly affected by age or cardiac disease. Our findings strongly support that including R-COMP is effective and safe when the population is at high risk of cardiac events and negatively selected. Moreover, the use of this NPLD permitted that about half of our population had the opportunity to receive the best available treatment.
Identifiants
pubmed: 32542788
doi: 10.1002/hon.2764
pmc: PMC7689940
doi:
Substances chimiques
liposomal doxorubicin
0
Polyethylene Glycols
3WJQ0SDW1A
Rituximab
4F4X42SYQ6
Vincristine
5J49Q6B70F
Doxorubicin
80168379AG
Cyclophosphamide
8N3DW7272P
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
478-486Informations de copyright
© 2020 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.
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