Prospective clinical study of R-CMD therapy for indolent B cell lymphoma and mantle cell lymphoma from the Hokuriku Hematology Oncology Study Group

• Published in: Medical oncology (Northwood, London, England) Vol. 32; no. 9; p. 232
• Main Authors: Sakai, Tomoyuki, Masaki, Yasufumi, Otsuki, Nozomi, Sakamaki, Ippei, Kishi, Shinji, Miyazono, Takayoshi, Urasaki, Yoshimasa, Murakami, Jun, Satoh, Tomomi, Nakamura, Takuji, Iwao, Haruka, Nakajima, Akio, Kawanami, Takafumi, Miki, Miyuki, Fujita, Yoshimasa, Tanaka, Masao, Fukushima, Toshihiro, Okazaki, Toshiro, Ueda, Takanori
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-09-2015; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cladribine - administration & dosage; Cladribine - adverse effects; Cladribine - therapeutic use; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Dexamethasone - therapeutic use; Female; Hematology; Humans; Internal Medicine; Lymphoma, B-Cell - drug therapy; Lymphoma, B-Cell - mortality; Lymphoma, Mantle-Cell - drug therapy; Lymphoma, Mantle-Cell - mortality; Male; Medicine; Medicine & Public Health; Middle Aged; Mitoxantrone - administration & dosage; Mitoxantrone - adverse effects; Mitoxantrone - therapeutic use; Oncology; Original Paper; Pathology; Prospective Studies; Rituximab - administration & dosage; Rituximab - adverse effects; Rituximab - therapeutic use; Indolent B cell lymphoma; Toxicity; R-CMD; Mantle cell lymphoma
• ISSN: 1357-0560; 1559-131X
• DOI: 10.1007/s12032-015-0677-9

Standardized treatments for indolent B cell lymphoma primarily consisting of follicular lymphoma (FL) and for mantle cell lymphoma (MCL) have yet to be established. Here the Hokuriku Hematology Oncology Study Group conducted a multicenter prospective study to investigate the efficacy and safety of a combination regimen of rituximab, cladribine, mitoxantrone, and dexamethasone (R-CMD) in indolent B cell lymphoma and MCL. A total of 33 CD20-positive patients who received care between January 2008 and August 2011 were investigated. These patients’ illnesses were FL (
n
 = 21), nodal marginal zone B cell lymphoma (NMZB,
n
 = 3), MCL (
n
 = 3), splenic marginal zone B cell lymphoma (
n
 = 2), hairy cell leukemia (
n
 = 1), Waldenstrom macroglobulinemia (WM,
n
 = 1), and lymphoplasmacytic lymphoma (LPL,
n
 = 2). Patients received four 21-day cycles of rituximab 375 mg/m
2
(day 1), cladribine 0.10 mg/kg (days 1–3), mitoxantrone 8 mg/m
2
(day 1), and dexamethasone 8 mg/body (days 1–3), with four additional rituximab doses at 4-week intervals. Of the 33 patients, 26 achieved complete response/unconfirmed complete response, and six achieved a partial response (4 with FL, 1 with NMZB, 1 with WM). One had progressive disease (FL), and four relapsed after remission (1 with FL, 2 with MCL, 1 with LPL). R-CMD therapy was relatively convenient and effective in indolent B cell lymphoma and MCL. Nonetheless, to suppress the number and function of both B cells and T cells, comprehensive infection prevention and follow-up are necessary in the future.