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Weekly rituximab consolidation following four cycles of R‐CHOP induction chemotherapy in very elderly patients with diffuse large B‐cell lymphoma: Consortium for improving survival of lymphoma study (CISL)
Authors:Sung‐Hoon Jung  Je‐Jung Lee  Won Seog Kim  Won‐Sik Lee  Young Rok Do  Sung Yong Oh  Min Kyoung Kim  Yeung‐Chul Mun  Ho‐Jin Shin  Jae‐Yong Kwak  Hye Jin Kang  Jong Ho Won  Jung Hye Kwon  Eunkyung Park  Cheolwon Suh  Deok‐Hwan Yang
Affiliation:1. Department of Hemato‐Oncology, Chonnam National University Hwasun Hospital, Jeollanam‐do, Korea;2. Department of Hemato‐Oncology, Samsung Medical Center, Seoul, Korea;3. Department of Hemato‐Oncology, Busan Paik Hospital, Inje University, Busan, Korea;4. Department of Hemato‐Oncology, Keimyung University Dongsan Medical Center, Daegu, Korea;5. Department of Hemato‐Oncology, Dong‐A Medical Center, Busan, Korea;6. Department of Hemato‐Oncology, Yeungnam University College of Medicine, Taegu, Korea;7. Department of Hemato‐Oncology, Ewha Womans University Hospital, Seoul, Korea;8. Department of Hemato‐Oncology, Busan National University Hospital, Busan, Korea;9. Department of Hemato‐Oncology, Chonbuk National University Medical School, Jeonju, Korea;10. Department of Hemato‐Oncology, Korea Institute of Radiological and Medical Sciences, Seoul, Korea;11. Department of Hemato‐Oncology, Soon Chun Hyang University, Seoul, Korea;12. Department of Hemato‐Oncology, Hallym University College of Medicine, Seoul, Korea;13. Department of Hemato‐Oncology, Chung‐Ang University Hospital, Seoul, Korea;14. Department of Hemato‐Oncology, Asan Medical Center, Seoul, Korea
Abstract:This study aimed to determine the objective response, toxicity, and clinical outcome of weekly rituximab consolidation after four cycles of R‐CHOP21 in very elderly patients with DLBCL. A prospective, multi‐institutional phase II trial was conducted on patients with previously untreated CD20+ DLBCL who were older than 70 yr. Patients were treated with four cycles of R‐CHOP21 followed by weekly consolidation with rituximab (375mg/m2, four times infusion) (NCT01181999). We also compared the clinical outcomes with an historical case‐matched control group treated conventionally with six cycles of R‐CHOP21. A total of 51 patients with newly diagnosed DLBCL were enrolled at 15 institutes between June 2010 and September 2013 . The median age was 76 yr (range: 70–89). Forty‐one of the 51 patients completed the planned rituximab consolidation (R‐consolidation). The overall response rate was 78.4%, comprising 74.5% with a complete response and 3.9% with a partial response. After a median follow‐up of 20.3 months, 2‐yr progression‐free survival and overall survival were 63.9% and 68.7%, respectively. No serious toxicities were reported during rituximab consolidation. Weekly rituximab consolidation following four cycles of R‐CHOP21 resulted in an acceptable response with high tolerability and could be a good compromise between efficacy and safety for elderly patients with DLBCL.
Keywords:elderly  diffuse large B‐cell lymphoma  rituximab consolidation
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