Rituximab plus reduced-dose cyclophosphamide, doxorubicin, vincristine and prednisone (RD R-CHOP) chemotherapy is feasible for very elderly patients (≥80 years) with B-cell lymphoma: analysis of treatment outcome

Abstract

Objective: The aim of this trial was to evaluate the treatment outcome of reduced-dose (RD)R-CHOP treatment in very elderly patients with B-cell lymphoma.Methods: This trial comprised 40 patients, aged ≥80 years, who were diagnosed with B-cell lymphoma and recruited at a single centre from 2007 to 2013. They received four to eight cycles of reduced-dose R-CHOP (rituximab 375 mg/m2 Day 0, cyclophosphamide 400 mg/m2 Day 1, epirubicin 35 mg/m2 Day 1, vincristine 1 mg Day 1 and prednisone 50 mg/m2 Days 1–5). The data of treatment responses and survival were collected and analysed comprehensively.Results: The median age was 83 years old (range, 80–93 years old) and the median follow-up duration was 40.86 months. The overall response rate (ORR) was 87.5%. With a 40.9-month follow-up, 3-year overall survival (OS), 3-year progression free survival (PFS) and 3-year event-free survival (EFS) were 17.2, 46.5 and 39.1%, respectively. Using multivariate analysis, we concluded that age ≥85 years; LVEF ≤70%; M-CIRS score ≥6 and ECOG-PS ≥2 were predictive poor prognostic factors.Conclusions: High response rate was concluded on very elderly B-cell lymphoma patients (≥80 years old) with reduced-dose R-CHOP. However, the very elderly patients with poor performance status and more complications benefit less from treatment.