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Fludarabine, cyclophosphamide, and rituximab in patients with advanced, untreated, indolent B-cell nonfollicular lymphomas
Phase 2 study of the Italian Lymphoma Foundation
Article first published online: 16 DEC 2011
Copyright © 2011 American Cancer Society
Volume 118, Issue 16, pages 3954–3961, 15 August 2012
How to Cite
Ferrario, A., Pulsoni, A., Olivero, B., Rossi, G., Vitolo, U., Tedeschi, A., Merli, F., Rigacci, L., Stelitano, C., Goldaniga, M., Mannina, D., Musto, P., Rossi, F., Gamba, E. and Baldini, L. (2012), Fludarabine, cyclophosphamide, and rituximab in patients with advanced, untreated, indolent B-cell nonfollicular lymphomas. Cancer, 118: 3954–3961. doi: 10.1002/cncr.26708
- Issue published online: 3 AUG 2012
- Article first published online: 16 DEC 2011
- Manuscript Accepted: 31 OCT 2011
- Manuscript Revised: 24 OCT 2011
- Manuscript Received: 31 AUG 2011
- indolent nonfollicular lymphomas;
Indolent nonfollicular non-Hodgkin B-cell lymphomas (INFLs) are clonal mature B-cell proliferations for which treatment has not been defined to date.
In this phase 2 study of patients with advanced INFL, the authors evaluated the efficacy and safety of first-line rituximab, fludarabine, and cyclophosphamide (FCR) as induction immunochemotherapy (rituximab 375 mg/m2 intravenously on day 1 of each cycle and on days 1 and 14 of cycles 4 and 5; fludarabine 25 mg/m2 intravenously on days 2-4, cyclophosphamide 250 mg/m2 intravenously on Days 2-4) every 28 days for 6 cycles followed by a maintenance phase with 4 infusions of rituximab (375 mg/m2 intravenously on day 1) every 2 months for responders.
Forty-seven patients were enrolled. Among 46 evaluable patients (28 men; median age, 59 years), 19 were diagnosed with lymphoplasmacytic lymphoma, 21 were diagnosed with small lymphocytic lymphoma, and 6 were diagnosed with nodal marginal zone lymphoma. The overall response rate after maintenance was 89.1% with a 67.4% complete remission (CR) rate (CR/unconfirmed CR) and a 21.7% partial response rate. After a median follow-up of 40.9 months, the failure-free survival and progression-free survival rates both were 90.1%, and the overall survival rate was 97.4%. The main toxicity was hematologic, and related grade 3 and 4 neutropenia was observed in 55.3% of patients.
FCR induction therapy followed by a short maintenance phase is a highly effective regimen with acceptable toxicity. Cancer 2012. © 2011 American Cancer Society.