While CHOP therapy is effective for malignant lymphoma, the optimum schedul
e for elderly patients remains controversial. The present study investigate
d the usefulness of reduced-dose CHOP therapy for elderly patients. Previou
sly untreated patients aged 65 years or older with intermediate to high-gra
de non-Hodgkin's lymphoma were given up reduced-dose CHOP therapy at 3-week
intervals. Group A patients were given 5/6 of the standard dose and Group
B received 7/12 of the standard dose. Filgrastim was administered when the
white blood cell count fell below 2,000 mu /L, Fifty-seven patients were ev
aluable and the scheduled therapy was completed in 37. For patients aged fr
om 65 to 79 years and for patients older than 80 years, the complete respon
se rare was 79.5% and 46.2%, overall 3-year survival was 58.2% and 30.4%. a
nd event-free 3-year survival was 49.3% and 44.4%. respectively. Major toxi
cities (greater than or equal to grade 3) included leukopenia in 42 patient
s and documented infection in 7 patients. Grade 3 cardiac plus renal failur
e, grade 3 peritonitis due to small bowel perforation, and grade 3 liver dy
sfunction occurred in 1 patient each. One patient died of toxicity (grade 4
hematological toxicity and pneumonia).
In conclusion, it seems that in the elderly patients with non-Hodgkin's lym
phoma, response to reduced-dose (5/6 dose) CHOP therapy is comparable to th
at for standard CHOP in younger adults. mainly because of improved dose-int
ensity.