COMBINATION OF FLUDARABINE, MITOXANTRONE, DEXAMETHASONE AND RITUXIMAB (R-FND) IN THE TREATMENT OF INDOLENT NON-HODGKIN B CELL LYMPHOMA - RETROSPECTIVE STUDY OF 60 CHINESE PATIENTS
(Abstract release date: 05/21/15)
EHA Library. Chan T. 06/12/15; 102722; PB1789
Disclosure(s): Queen Mary Hospital, Hong KongMedicine
Thomas Sau Yan Chan
Contributions
Contributions
Abstract
Abstract: PB1789
Type: Publication Only
Background
Indolent non-Hodgkin B cell lymphomas (NHL) are a group of lymphoid malignancies that typically follows a protracted clinical course with frequent relapses. Although it is generally considered incurable, effective treatment regimens exist. The combination of fludarabine, mitoxantrone and dexamethasone (FND) resulted in high complete remission (CR) rate in the pre-rituximab era. Data are scarce on whether the addition of rituximab (R-FND) would result in a better CR rate or longer remission. Moreover, this combination has never been properly evaluated in Chinese patients, a population that reportedly has a much lower prevalence of indolent NHL.
Aims
To determine the efficacy of RFND regimen in indolent lymphomas in Chinese patients
Methods
Consecutive patients who are diagnosed with indolent NHL (follicular lymphoma, marginal zone lymphoma, lymphoplasmacytic lymphoma and low grade B cell lymphoproliferative disease (B-LPD) not otherwise classified) were recruited into this retrospective study from January 2012 to December 2014. The R-FND regimen (Rituximab 375mg/m2 on D1, Fludarabine 40mg/m2 daily D1-3, mitoxantrone 10mg/m2 on D1 and dexamethasone 20mg daily D1-5) was used as frontline treatment in our institution. Baseline demographic data were collected. Response rate and toxicity of the regimen was evaluated. Overall survival and progression free survival was analyzed using Kaplan-Meier method.
Results
Sixty patients (29 men, 31 women) (follicular, N=22; marginal zone lymphoma, N=27; lymphoplasmacytic lymphoma, N=4; B-LPD not otherwise classified, N=7) at a median age of 61 years were treated, with R-FND given as frontline therapy in 50 patients and salvage therapy in 10 patients. Stage III/IV disease occurred in the majority of the cases (N=42, 70%). The median follow up time was 23 months. Complete remission (CR) was achieved in 49 out of 59 evaluated patients (83.1%), and partial remission (PR) in 8 patients (13.6%), giving an overall response rate (ORR) of 96.7%. The response was also durable, with a progression free survival at 2 years of 81.3%. The overall survival at 2 years was 93.4%. Haematological toxicities were the most common adverse effects, with grade III/IV anaemia, neutropenia and thrombocytopenia being 10%, 88% and 17% respectively. Clinically significant cytomegalovirus (CMV) reactivation occurred in 8 patients (13%) with 2 of them developing CMV retinitis.
Summary
R-FND is a highly effective regimen with high CR rate and long duration of remission. However, due care should be taken with respect to haematological toxicity.
Keyword(s): Fludarabine, Indolent non-Hodgkin's lymphoma, Mitoxantrone, Rituximab
Session topic: Publication Only
Type: Publication Only
Background
Indolent non-Hodgkin B cell lymphomas (NHL) are a group of lymphoid malignancies that typically follows a protracted clinical course with frequent relapses. Although it is generally considered incurable, effective treatment regimens exist. The combination of fludarabine, mitoxantrone and dexamethasone (FND) resulted in high complete remission (CR) rate in the pre-rituximab era. Data are scarce on whether the addition of rituximab (R-FND) would result in a better CR rate or longer remission. Moreover, this combination has never been properly evaluated in Chinese patients, a population that reportedly has a much lower prevalence of indolent NHL.
Aims
To determine the efficacy of RFND regimen in indolent lymphomas in Chinese patients
Methods
Consecutive patients who are diagnosed with indolent NHL (follicular lymphoma, marginal zone lymphoma, lymphoplasmacytic lymphoma and low grade B cell lymphoproliferative disease (B-LPD) not otherwise classified) were recruited into this retrospective study from January 2012 to December 2014. The R-FND regimen (Rituximab 375mg/m2 on D1, Fludarabine 40mg/m2 daily D1-3, mitoxantrone 10mg/m2 on D1 and dexamethasone 20mg daily D1-5) was used as frontline treatment in our institution. Baseline demographic data were collected. Response rate and toxicity of the regimen was evaluated. Overall survival and progression free survival was analyzed using Kaplan-Meier method.
Results
Sixty patients (29 men, 31 women) (follicular, N=22; marginal zone lymphoma, N=27; lymphoplasmacytic lymphoma, N=4; B-LPD not otherwise classified, N=7) at a median age of 61 years were treated, with R-FND given as frontline therapy in 50 patients and salvage therapy in 10 patients. Stage III/IV disease occurred in the majority of the cases (N=42, 70%). The median follow up time was 23 months. Complete remission (CR) was achieved in 49 out of 59 evaluated patients (83.1%), and partial remission (PR) in 8 patients (13.6%), giving an overall response rate (ORR) of 96.7%. The response was also durable, with a progression free survival at 2 years of 81.3%. The overall survival at 2 years was 93.4%. Haematological toxicities were the most common adverse effects, with grade III/IV anaemia, neutropenia and thrombocytopenia being 10%, 88% and 17% respectively. Clinically significant cytomegalovirus (CMV) reactivation occurred in 8 patients (13%) with 2 of them developing CMV retinitis.
Summary
R-FND is a highly effective regimen with high CR rate and long duration of remission. However, due care should be taken with respect to haematological toxicity.
Keyword(s): Fludarabine, Indolent non-Hodgkin's lymphoma, Mitoxantrone, Rituximab
Session topic: Publication Only
Abstract: PB1789
Type: Publication Only
Background
Indolent non-Hodgkin B cell lymphomas (NHL) are a group of lymphoid malignancies that typically follows a protracted clinical course with frequent relapses. Although it is generally considered incurable, effective treatment regimens exist. The combination of fludarabine, mitoxantrone and dexamethasone (FND) resulted in high complete remission (CR) rate in the pre-rituximab era. Data are scarce on whether the addition of rituximab (R-FND) would result in a better CR rate or longer remission. Moreover, this combination has never been properly evaluated in Chinese patients, a population that reportedly has a much lower prevalence of indolent NHL.
Aims
To determine the efficacy of RFND regimen in indolent lymphomas in Chinese patients
Methods
Consecutive patients who are diagnosed with indolent NHL (follicular lymphoma, marginal zone lymphoma, lymphoplasmacytic lymphoma and low grade B cell lymphoproliferative disease (B-LPD) not otherwise classified) were recruited into this retrospective study from January 2012 to December 2014. The R-FND regimen (Rituximab 375mg/m2 on D1, Fludarabine 40mg/m2 daily D1-3, mitoxantrone 10mg/m2 on D1 and dexamethasone 20mg daily D1-5) was used as frontline treatment in our institution. Baseline demographic data were collected. Response rate and toxicity of the regimen was evaluated. Overall survival and progression free survival was analyzed using Kaplan-Meier method.
Results
Sixty patients (29 men, 31 women) (follicular, N=22; marginal zone lymphoma, N=27; lymphoplasmacytic lymphoma, N=4; B-LPD not otherwise classified, N=7) at a median age of 61 years were treated, with R-FND given as frontline therapy in 50 patients and salvage therapy in 10 patients. Stage III/IV disease occurred in the majority of the cases (N=42, 70%). The median follow up time was 23 months. Complete remission (CR) was achieved in 49 out of 59 evaluated patients (83.1%), and partial remission (PR) in 8 patients (13.6%), giving an overall response rate (ORR) of 96.7%. The response was also durable, with a progression free survival at 2 years of 81.3%. The overall survival at 2 years was 93.4%. Haematological toxicities were the most common adverse effects, with grade III/IV anaemia, neutropenia and thrombocytopenia being 10%, 88% and 17% respectively. Clinically significant cytomegalovirus (CMV) reactivation occurred in 8 patients (13%) with 2 of them developing CMV retinitis.
Summary
R-FND is a highly effective regimen with high CR rate and long duration of remission. However, due care should be taken with respect to haematological toxicity.
Keyword(s): Fludarabine, Indolent non-Hodgkin's lymphoma, Mitoxantrone, Rituximab
Session topic: Publication Only
Type: Publication Only
Background
Indolent non-Hodgkin B cell lymphomas (NHL) are a group of lymphoid malignancies that typically follows a protracted clinical course with frequent relapses. Although it is generally considered incurable, effective treatment regimens exist. The combination of fludarabine, mitoxantrone and dexamethasone (FND) resulted in high complete remission (CR) rate in the pre-rituximab era. Data are scarce on whether the addition of rituximab (R-FND) would result in a better CR rate or longer remission. Moreover, this combination has never been properly evaluated in Chinese patients, a population that reportedly has a much lower prevalence of indolent NHL.
Aims
To determine the efficacy of RFND regimen in indolent lymphomas in Chinese patients
Methods
Consecutive patients who are diagnosed with indolent NHL (follicular lymphoma, marginal zone lymphoma, lymphoplasmacytic lymphoma and low grade B cell lymphoproliferative disease (B-LPD) not otherwise classified) were recruited into this retrospective study from January 2012 to December 2014. The R-FND regimen (Rituximab 375mg/m2 on D1, Fludarabine 40mg/m2 daily D1-3, mitoxantrone 10mg/m2 on D1 and dexamethasone 20mg daily D1-5) was used as frontline treatment in our institution. Baseline demographic data were collected. Response rate and toxicity of the regimen was evaluated. Overall survival and progression free survival was analyzed using Kaplan-Meier method.
Results
Sixty patients (29 men, 31 women) (follicular, N=22; marginal zone lymphoma, N=27; lymphoplasmacytic lymphoma, N=4; B-LPD not otherwise classified, N=7) at a median age of 61 years were treated, with R-FND given as frontline therapy in 50 patients and salvage therapy in 10 patients. Stage III/IV disease occurred in the majority of the cases (N=42, 70%). The median follow up time was 23 months. Complete remission (CR) was achieved in 49 out of 59 evaluated patients (83.1%), and partial remission (PR) in 8 patients (13.6%), giving an overall response rate (ORR) of 96.7%. The response was also durable, with a progression free survival at 2 years of 81.3%. The overall survival at 2 years was 93.4%. Haematological toxicities were the most common adverse effects, with grade III/IV anaemia, neutropenia and thrombocytopenia being 10%, 88% and 17% respectively. Clinically significant cytomegalovirus (CMV) reactivation occurred in 8 patients (13%) with 2 of them developing CMV retinitis.
Summary
R-FND is a highly effective regimen with high CR rate and long duration of remission. However, due care should be taken with respect to haematological toxicity.
Keyword(s): Fludarabine, Indolent non-Hodgkin's lymphoma, Mitoxantrone, Rituximab
Session topic: Publication Only
{{ help_message }}
{{filter}}