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ePoster Display

838P - Rituximab and non-pegylated liposomial doxorubincin (R-NPLD) treatment in patients 80 years of age or older affected by diffuse large B-cell lymphoma (DLBCL): A 2020 update and implications of clinical and pathological factors

Date

16 Sep 2021

Session

ePoster Display

Presenters

Chiara Cantò

Citation

Annals of Oncology (2021) 32 (suppl_5): S773-S785. 10.1016/annonc/annonc676

Authors

C. Cantò1, E. Pennese1, M. Di Nicola2, G. Ricciuti3, F. Restuccia1, S. Luciani1, F. Angrilli1

Author affiliations

  • 1 Department Of Oncology And Hematology, Spirito Santo Hospital, Center for the Diagnosis and Treatment of Lymphomas, 65124 - Pescara/IT
  • 2 Department Of Medical, Oral And Biotechnological Sciences,, Department of Medical, Oral and Biotechnological Sciences, “G. d’Annunzio” University, 66100 - Chieti/IT
  • 3 Department Of Hematology, IRCCS "Casa Sollievo della Sofferenza", 6512471013 - San Giovanni Rotondo/IT
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Abstract 838P

Background

In 2018 we report a rituximab plus nonpegylated liposomial doxorubicin (R-NPLD) combination for patients 80 years or older with diffuse B cell lymphoma (DLBCL) or grade 3 b follicular lymphoma. The overall 3-year survival, cause-specific survival and progression-free survival rates were 46%, 55%, and 44%, respectively. According to these results, R-NPLD has become the new standard treatment in patients > 80 years old with aggressive B lymphoma, in our institution. To better investigate the prognostic role of clinical and pathological factors, we analyzed the same combination in a larger cohort of patient 80 years or older with DLBCL.

Methods

We retrospectively and prospectively analyzed data of patients 80 years or older with untreated CD20-positive DLBCL. Patients received a combination treatment with rituximab plus nonpegylated liposomial doxorubicin. The regimen consisted of R 375 mg/sqm and NPLD 50 mg/sqm administered intravenously on cycle day 1, plus prednisone 50 mg orally on days 1 to 5, every 21 days for 6 courses.

Results

Between May 2010 and April 2019, we enrolled 50 patients (median age 84, range 80-96). The median FU time was 28 months (range 10-104). The overall 3-years survival, cause-specific survival, and disease free survival rates were 49.9+7.6%,55.5+7.9%, and 48.5+7.8%. Treatment was well tolerated with mild toxicities, without treatment related hospitalization or toxic deaths. Patients achieving EFS12 and EFS18 had an overall 3-years survival of 66+13.0% and 67.9+7.0%, respectively.

Conclusions

Our results confirm that, in patients 80 years or older with DLBCL, R-NPDL is very effective and safe combination. Among prognostic factors, elevated LDH (> 1.25 upper limit) strongly correlates with overall survival and risk of relapse, in univariate (p=0.001, p=0.003) and multivariate (p=0.002, p=0.005) analysis. In patients who achieved EFS18 the probability to survive 24 and 36 months is of 90.5 and 67.9%, respectively, suggesting that EFS18 will be useful in patient counseling and should be considered as a robust end point for future studies of newly diagnosed very elderly DLBCL patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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