A multicenter, phase II study of R-THP-COP therapy for elderly patients with newly diagnosed, advanced-stage, indolent B-cell lymphoma

• Published in: Journal of Clinical and Experimental Hematopathology 2021, Vol.61(3), pp.162-167
• Main Authors: Ohnishi, Kazunori, Ohmachi, Ken, Ando, Kiyoshi, Yamamoto, Kazuhito, Ito, Tatsuya, Tanimoto, Mitsune, Ohbayashi, Kaneyuki, Ohyashiki, Kazuma, Tsukasaki, Kunihiro, Naito, Kensuke, Suzuki, Takayo, Ono, Takaaki, Miyamura, Koichi, Kagami, Yoshitoyo, Kinoshita, Tomohiro, Hotta, Tomomitsu, Ogura, Michinori
• Format: Article
• Language: English
• Subjects: elderly patients; Indolent B-cell lymphoma; Original; R-THP-COP
• ISSN: 1346-4280; 1880-9952
• DOI: 10.3960/jslrt.21004

The optimal combined chemotherapy regimen with rituximab has yet to be established for elderly patients with advanced-stage indolent B-cell lymphoma (B-NHL). A multicenter study was performed to evaluate the efficacy and toxicity of R-THP-COP therapy in elderly patients (aged 70–79 years) with newly diagnosed advanced-stage indolent B-NHL using the complete response rate (%CR) as the primary endpoint. Patients with newly diagnosed, clinical stage III/IV, indolent B-NHL, aged 70–79 years, with a performance status of 0–2 were eligible for this study. R-THP-COP consists of 375 mg/m2 of rituximab, 50 mg/m2 of pirarubicin, 750 mg/m2 of cyclophosphamide, 1.4 mg/m2 of vincristine, and 100 mg/day of oral prednisolone for 5 days. This study was discontinued due to poor accrual after the enrollment of 18 patients, although the planned sample size was 40 patients. The numbers of patients with follicular lymphoma, mucosa-associated lymphoid tissue lymphoma, and mantle cell lymphoma were 16, 1, and 1, respectively. The median age was 73 (range, 70 to 79) years. The %CR including unconfirmed CR was 45% (95% confidence interval: 25-66%) and the overall response rate was 72%. The estimated 5-year overall survival and progression-free survival rates were 55% and 28%, respectively. The major toxicity observed was grade 4 neutropenia (94%). Grade 4 non-hematological toxicities were not observed and no patients developed grade 3/4 cardiac toxicities. This phase II study provides useful information regarding the efficacy and toxicity of R-THP-COP therapy for patients aged 70 years or older with newly diagnosed, advanced-stage, indolent B-NHL, although the sample size was small.