EFFECT OF GRANULOCYTE-COLONY-STIMULATING FACTOR ADMINISTRATION IN ELDERLY PATIENTS WITH AGGRESSIVE NON-HODGKINS-LYMPHOMA TREATED WITH A PIRARUBICIN-COMBINATION CHEMOTHERAPY REGIMEN
A. Guerci et al., EFFECT OF GRANULOCYTE-COLONY-STIMULATING FACTOR ADMINISTRATION IN ELDERLY PATIENTS WITH AGGRESSIVE NON-HODGKINS-LYMPHOMA TREATED WITH A PIRARUBICIN-COMBINATION CHEMOTHERAPY REGIMEN, Annals of oncology, 7(9), 1996, pp. 966-969
Purpose: Results of a multidrug chemotherapy regimen consisting of cyc
lophosphamide, pirarubicin, teniposide, and prednisolone (CTVP) plus s
ubcutaneous granulocyte colony-stimulating factor (G-CSF) in elderly p
atients with aggressive non-Hodgkin's lymphoma (NHL) are reported. Pat
ients and methods: Between January and December 1992, 46 previously un
treated patients older than 69 years with intermediate- and high-grade
NHL received cyclophosphamide 750 mg/m(2), teniposide 75 mg/m(2), pir
arubicin 50 mg/m(2) day 1, and prednisolone 40 mg/m(2) days 1 to 3. G-
CSF, 5 mu g/kg/day, was administered from day 4 up to day 14 or when t
he absolute neutrophil count reached 5 x 10(9)/l. Six cycles were sche
duled every 3 weeks. Results: Grade 3 or grade 4 neutropenia complicat
ed 22% and 26% of chemotherapy cycles, respectively. Fever or/and clin
ical infection were observed in 4% and 14% of cycles. One toxic death
related to a septic shock occurred. Eight cycles (4%) were delayed wit
h a median duration of 7 days. Administered median dose intensity was
93.5%. Objective response rate was 74% and 46% of the patients achieve
d a complete response. The 2-year overall survival and event-free surv
ival rates were 47% and 28%. Conclusion: in comparison with a previous
group of patients treated with CTVP, G-CSF allows delivery of chemoth
erapy with a reduced neutropenia-induced morbidity in an outpatient se
tting in elderly patients with aggressive NHL without modifying respon
se rate or survival.