Aim: To evaluate toxicity and efficacy of CDxOP regimen in the treatment of primary non-Hodgkin's lymphoma (PNHL).
Material and methods: The study included 8 males and 6 females who had large B-cell lymphoma (n = 11), follicular lymphoma, predominantly large cell (n = 1), mantle cell lymphoma (n = 1) and peripheral T-cell lymphoma (n = 1). Seven patients were over 60. PNHL stage IV, III and II was diagnosed in 7, 5 and 2 patients, respectively. Daunoxome dose was 80 mg/m2 with an increase up to 100 mg/m2 in case of slow response and good tolerance. The other drugs were used in standard doses.
Results: 6 patients achieved complete remission (43%) and 5 patients--partial response (36%), the overall response was 79%. Three patients did not respond to therapy and died. Six patients are still in complete and two in partial remission, median follow-up being 22 months. The rest 3 patients were treated with other modalities, one of them died of infection. As to complications that might be related to daunoxome, there was myelodepression (6% of profound neutropenia < 1000 microl). No patients had deterioration of the left ventricular ejection fraction (ultrasound measurements) or clinical signs of congestive heart failure (median follow-up for 10 patients was 22 months) including those in whom high cumulative doses were used (640-840 mg/m2). One patient with compromised heart function had frequent ventricular extrasystole immediately after daunoxome infusion.
Conclusion: Tolerance of CDxOP is acceptable. The results of the treatment are comparable with those of standard chemotherapy. Further comparative studies are needed for determination of efficacy and maximal tolerated dose of daunoxome in combination with other drugs and irradiation, of long-term side effects. This drug may be beneficial for elderly patients.