Korean J Hematol.  2011 Sep;46(3):180-185. 10.5045/kjh.2011.46.3.180.

Fludarabine-containing chemotherapy for patients with previously untreated low-grade non-Hodgkin's lymphoma

• Ahn JS
• Yang DH
• Jung SH
• Bae SY
• Tran HT
• Park HC
• Kim HN
• Kim YK
• Kim HJ
• Lee JJ

• KMID: 2252001
• DOI: http://doi.org/10.5045/kjh.2011.46.3.180

Abstract

BACKGROUND
The clinical efficacy and safety of fludarabine combination chemotherapy was investigated for the treatment of previously untreated patients with low-grade (NHL).
METHODS
Twenty-five patients who were newly diagnosed as low-grade NHL were treated with fludarabine combination chemotherapy. Fludarabine combination regimens consisted of fludarabine, mitoxantrone and dexamethasone or fludarabine, cyclophosphamide and mitoxantrone with or without rituximab and repeated every 4 weeks.
RESULTS
The median age was 60 years (range, 35-77 years), with 13 of 25 patients (52%) > or =60 years of age. Seven of 25 patients (28%) with an intermediate risk follicular lymphoma international prognostic index (FLIPI) and 9 of 25 patients (36%) with a high risk FLIPI were enrolled in this study. The delivered median number of chemotherapy was six (range, 2-9 cycles). The overall response rate with fludarabine-based treatment was 88%, including 52% complete remission and 36% partial remission. During the median follow-up of 19 months, the estimated 2-year event-free survival was 63+/-10% (95% CI, 43-83) and the 2-year overall survival was 78+/-9% (95% CI, 60-96). Fludarabine combination chemotherapy was frequently associated with grade 3 or 4 neutropenia in 84% patients. However, neutropenic infection was observed in only one (4%) patient. Four patients (16%) showed grade 3 or more non-hematologic toxicities, such as acute coronary syndrome, intracranial hemorrhage, anaphylaxis and gastric cancer.
CONCLUSION
Fludarabine-combination treatment was a highly active regimen with well toleration in untreated low-grade NHL.

Keyword

Fludarabine; Primary; Lymphoma

MeSH Terms

Acute Coronary Syndrome
Anaphylaxis
Antibodies, Monoclonal, Murine-Derived
Cyclophosphamide
Dexamethasone
Disease-Free Survival
Drug Therapy, Combination
Follow-Up Studies
Humans
Intracranial Hemorrhages
Lymphoma
Lymphoma, Follicular
Lymphoma, Non-Hodgkin
Mitoxantrone
Neutropenia
Vidarabine
Rituximab
Antibodies, Monoclonal, Murine-Derived
Cyclophosphamide
Dexamethasone
Mitoxantrone
Vidarabine

Figure

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  Fig. 1 Event-free survival and overall survival following fludarabine combination chemotherapy in untreated indolent non-Hodgkin's lymphoma.

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