12th Congress of the European Hematology ... - Haematologica

0867
COMPREHENSIVE GERIATRIC ASSESSMENT-ADAPTED CHEMOTHERAPY IN 100 ELDERLY
PATIENTS (>70 YEARS) WITH DIFFUSE LARGE B-CELL NON-HODGKINS LYMPHOMA
M. Spina, 1 M. Balzarotti, 2 L. Uziel, 3 A. Ferreri, 4 L. Fratino, 1
A. Giacalone, 1 E. Vaccher, 1 A. Santoro, 2 U. Tirelli 1
1 National Cancer Institute, AVIANO (PN); 2 Humanitas Institute, ROZZANO
(MI); 3 San Paolo Hospital, MILAN; 4 San Raffaele Hospital, MILAN, Italy
Background. Rituximab plus CHOP (R-CHOP) is the standard
chemotherapy (CT) regimen for elderly patients (pts) with CD20 positive
DLBCL. However, many pts aged 70 years (yrs) or more are often unable
to received R-CHOP and the majority of them are excluded from clinical
trials. Moreover, comprehensive geriatric assessment (CGA) has been
demonstrated a useful instrument to predict the clinical outcome of elderly
pts with cancer even if it has never been tested in a prospective way.
Aims. Within the GOL (Gruppo Oncoematologico Linfomi) from June
2000 to March 2006 we started a phase II prospective study with the aim
to evaluate feasibility and activity of a CGA-driven CT for elderly pts
with DLBCL. Methods. Rituximab was used in all pts after its introduction
in the marketing in Italy (February 2002). Pts with no comorbidity
received CHOP or R-CHOP; in pts with mild cardiopathy epirubicin was
used instead of doxorubicin (CEOP or R-CEOP); in pts with moderate or
severe cardiopathy the use of antracyclines was omitted (CVP or R-CVP);
pts with diabetes didn’t receive prednisone (CHO, CEO or R-CHO, R-
CEO); pts with neuropathy received CHP or R-CHP or CEP or R-CEP
(vincristine was omitted). The dosage of CT was decided according to
CGA: pts with a good score of CGA (i.e. ADL=6 and IADL>6) received
full doses of CT; pts with an intermediate score (ADL=5 and IADL>4)
received 75% of the planned dose; pts with a poor score (ADL