Fludarabine phosphate–CVP in patients over 60 years of age with advanced, low-grade and follicular lymphoma: A dose-finding study

The aim of this study was to establish a safe and effective regimen of fludarabine phosphate, cyclophosphamide, vincristine and prednisone (F–CVP) as first-line treatment for elderly patients with advanced, low-grade non-Hodgkin’s lymphoma. Twenty-three patients >60 years were assigned successive...

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Bibliographic Details
Published in:	European journal of cancer (1990) Vol. 41; no. 17; pp. 2630 - 2636
Main Authors:	Soubeyran, Pierre, Monnereau, Alain, Eghbali, Houchingue, Soubeyran, Isabelle, Kind, Michèle, Cany, Laurent, Buy, Elizabeth, Guibon, Odile, Hœrni, Bernard
Format:	Journal Article
Language:	English
Published:	Oxford Elsevier Ltd 01-11-2005 Elsevier
Subjects:	Administration, Oral Aged Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Cyclophosphamide - administration & dosage Dose-Response Relationship, Drug Female Fludarabine phosphate Follicular lymphoma Humans Infusions, Intravenous Lymphoma, Follicular - drug therapy Lymphoma, Follicular - pathology Male Maximum Tolerated Dose Medical sciences Middle Aged Non-Hodgkin’s lymphoma Pharmacology. Drug treatments Prednisone - administration & dosage Survival Analysis Treatment Outcome Tumors Vidarabine Phosphate - administration & dosage Vidarabine Phosphate - analogs & derivatives Vincristine - administration & dosage Non-Hodgkin’s lymphoma Fludarabine phosphate Follicular lymphoma Antineoplastic agent Human Phosphates Purine nucleotide Malignant hemopathy Pharmacology Non Hodgkin lymphoma Non-Hodgkin's lymphoma Cancerology Fludarabine Antimetabolic Lymphoproliferative syndrome Advanced stage Fluorine Organic compounds Dose Elderly Age Low grade
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Summary:	The aim of this study was to establish a safe and effective regimen of fludarabine phosphate, cyclophosphamide, vincristine and prednisone (F–CVP) as first-line treatment for elderly patients with advanced, low-grade non-Hodgkin’s lymphoma. Twenty-three patients >60 years were assigned successively to eight treatment cycles (Dose level 1: low F, low CV [ n = 4]; 2A: high F, low CV [ n = 8]; 2B: low F, high CV [ n = 4]; 3: high F, high CV [ n = 7]). High and low levels were: F, 25 and 20 mg/m 2, respectively (Days 1–5); C, 750 and 500 mg/m 2, respectively (Day 1); and V, 1.4 and 1 mg/m 2, respectively (Day 1). Patients received P at 40 mg/m 2 on Days 1–5. Response was assessed after Cycles 2, 4, 6 and 8. At level 3, dose-limiting toxicity (opportunistic infections and neutropenia) became evident, particularly after Cycle 6. Further patients were recruited at Dose level 2A. All regimens proved effective, with an OR rate of 78% (65% CR), and 3-year survival of 65% (±10%). Among 18 responders, 51% were still in response at 3 and 5 years. The study shows that this combination therapy is highly effective. The addition of F to CVP at Dose level 2A was feasible and increased the CR rate, with good tolerability in elderly patients.
ISSN:	0959-8049 1879-0852
DOI:	10.1016/j.ejca.2005.08.021