Korean J Hematol 2011; 46(3):
Published online September 30, 2011
https://doi.org/10.5045/kjh.2011.46.3.180
© The Korean Society of Hematology
1Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
2The Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University Medical School, Gwangju, Korea.
Correspondence to : Correspondence to Je-Jung Lee, M.D., Ph.D. Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun 519-809, Korea. Tel: +82-61-379-7638, Fax: +82-61-379-7628, drjejung@chonnam.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
The clinical efficacy and safety of fludarabine combination chemotherapy was investigated for the treatment of previously untreated patients with low-grade (NHL).
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.
The median age was 60 years (range, 35-77 years), with 13 of 25 patients (52%) ≥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.
Fludarabine-combination treatment was a highly active regimen with well toleration in untreated low-grade NHL.
Keywords Fludarabine, Primary, Lymphoma
Korean J Hematol 2011; 46(3): 180-185
Published online September 30, 2011 https://doi.org/10.5045/kjh.2011.46.3.180
Copyright © The Korean Society of Hematology.
Jae-Sook Ahn1, Deok-Hwan Yang1, Sung-Hoon Jung1, Soo-Young Bae1, Huong Thi Thanh Tran1, Hyung Chul Park1, Ha-Na Kim1, Yeo-Kyeoung Kim1, Hyeoung-Joon Kim1, and Je-Jung Lee1,2*
1Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, Hwasun, Korea.
2The Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University Medical School, Gwangju, Korea.
Correspondence to: Correspondence to Je-Jung Lee, M.D., Ph.D. Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun 519-809, Korea. Tel: +82-61-379-7638, Fax: +82-61-379-7628, drjejung@chonnam.ac.kr
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
The clinical efficacy and safety of fludarabine combination chemotherapy was investigated for the treatment of previously untreated patients with low-grade (NHL).
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.
The median age was 60 years (range, 35-77 years), with 13 of 25 patients (52%) ≥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.
Fludarabine-combination treatment was a highly active regimen with well toleration in untreated low-grade NHL.
Keywords: Fludarabine, Primary, Lymphoma
Event-free survival and overall survival following fludarabine combination chemotherapy in untreated indolent non-Hodgkin's lymphoma.
Table 1 . Characteristics of 25 patients with low-grade non- Hodgkin's lymphoma..
Abbreviations: SLL, small lymphocytic lymphoma; FL, follicular lymphoma; MZBCL, marginal zone B cell lymphoma; IPI, international prognostic index; FLIPI, follicular lymphoma international prognostic index; PS, performance scale; FND, fludarabine, mitoxantrone, and dexamethasone; FCM±R, fludarabine, cyclophosphamide, and mitoxantrone±rituximab..
Table 2 . Treatment result of fludarabine-combination chemotherapy according to tumor subtype..
Abbreviations: CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease; OR, overall response..
Table 3 . Adverse events during fludarabine-combination chemotherapy according to cycles and patients..
Abbreviations: AST, aspartate aminotransferase; ALT, alanine transaminase..
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Event-free survival and overall survival following fludarabine combination chemotherapy in untreated indolent non-Hodgkin's lymphoma.