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Volume 41, Issue 17, Pages 2630-2636 (November 2005)


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

Pierre SoubeyranCorresponding Author Informationemail address, Alain Monnereau, Houchingue Eghbali, Isabelle Soubeyran, Michèle Kind, Laurent Cany, Elizabeth Buy, Odile Guibon, Bernard Hœrni

Received 24 November 2004; received in revised form 19 August 2005; accepted 23 August 2005.

Abstract 

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 20mg/m2, respectively (Days 1–5); C, 750 and 500mg/m2, respectively (Day 1); and V, 1.4 and 1mg/m2, respectively (Day 1). Patients received P at 40mg/m2 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.

The Institute Bergonié, Regional Cancer Center, 229 cours de l’Argonne, 33076 Bordeaux Cedex, France and Schering AG, Lys Lez Lannoy, France

Corresponding Author InformationCorresponding author. Tel.: +33 556 33 32 67; fax: +33 5 556 33 33 83.

PII: S0959-8049(05)00723-9

doi:10.1016/j.ejca.2005.08.021


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