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Lymphoma and Pets
Adding Revlimid to RCHOP21 Looks Good in Elderly DLBCL Patients
An open-label phase II study demonstrates the safety and efficacy of adding lenalidomide to RCHOP21 for elderly patients with treatment naïve diffuse large B-cell lymphoma (DLBCL).
According to Umberto Vitolo MD of Azienda Ospedaliera Citta della Salute e della Scienza di Torino in Italy and colleagues, as many as 40 percent of this patient population that receives RCHOP21 (the RCHOP regimen delivered on a 21 day cycle) will relapse or develop refractory disease.
Since lenalidomide (brand name: Revlimid) is known to be active against relapsed or refractory B-cell lymphomas, Vitolo and his colleagues decided to see if it would help response rates among this population.
They recruited 49 patients aged 69 to 80 with newly diagnosed and untreated CD20 positive stage II-IV DLBCL or grade 3b follicular lymphoma.
Patients were given 15 mg oral lenalidomide on days 1 through 14 of the 21 day cycle for a total of six cycles, coupled with standard doses of RCHOP21.
Their findings indicated that 45 of 49 patients, or 91.8 percent, achieved some response, while 42 patients achieved a complete response and the other three, a partial response. One patient died of causes unrelated to lymphoma or treatment.
Furthermore, patients appeared able to tolerate the treatment, with 94 percent of planned treatment cycles completed.
Adverse events included grade 3 or 4 neutropenia, leukopenia, and thrombocytopenia.