Treatment outcomes of dose-attenuated CHOP chemotherapy in elderly patients with peripheral T cell lymphoma

Eun Ji Choi, Jung Yong Hong, Dok Hyun Yoon, Jihoon Kang, Chan Sik Park, Jooryung Huh, Eun Jin Chae, Yoonse Lee, Jin Sook Ryu, Cheolwon Suh

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background While cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is the most commonly used chemotherapeutic regimen for patients with peripheral T-cell lymphomas (PTCLs), elderly patients are more vulnerable to associated toxicities. We evaluated the efficacy and safety of dose-attenuated CHOP in elderly patients with PTCL. Methods Patients with PTCL aged > 70 years or 65-70-years with comorbidities were treated with dose-attenuated CHOP (cyclophosphamide: 562.5 mg/m2, doxorubicin: 37.5 mg/m2, vincristine: 1.4 mg/m2, and prednisolone: 100 mg for five days; 25% reduced dose of cyclophosphamide and doxorubicin vs. full-dose CHOP) as first-line therapy were included. Results Forty-four patients (median age, 74 yr) were analyzed. The majority (N=42, 95.5%) had advanced stage disease and 36 (81.8%) were classified as high/high-intermediate risk by the international prognostic index. The overall response rate was 61.4%, and 21 patients achieved complete response (47.7%). With median follow-up period of 28.8 months, the estimated two-year progression-free and overall survival rates were 36.7% and 46.6%, respectively. Grade 3/4 neutropenia and thrombocytopenia occurred in 26.9% and 7.4% of 204 total cycles, which affected 76.7% and 25.6% of the patients, respectively. Nineteen patients (44.2%) experienced febrile neutropenia, and six died due to treatment-related toxicities. High lactate dehydrogenase levels and an involvement of > 1 extranodal sites were prognostic indicators of poor survival. Conclusion Dose-attenuated CHOP does not compromise treatment efficacy but retains significant toxicity. Our results suggest that some patients can be effectively treated with dose-attenuated CHOP, however a novel therapy for elderly patients with PTCL is required.

Original languageEnglish (US)
Pages (from-to)270-275
Number of pages6
JournalBlood Research
Volume52
Issue number4
DOIs
StatePublished - 2017

Bibliographical note

Publisher Copyright:
© 2017 Korean Society of Hematology.

Keywords

  • Dose-attenuated CHOP
  • Elderly
  • Peripheral T cell lymphoma

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