A NEW PROTOCOL (MICEP) FOR THE TREATMENT OF INTERMEDIATE OR HIGH-GRADE NON-HODGKINS-LYMPHOMA IN THE ELDERLY

Age has proved to be an important prognostic factor in patients with a dvanced non-Hodgkin lymphoma (NHL) and these patients require intensiv e and extensive therapy. Dose-reduction and therapy attenuation have r educed treatment-related toxicity, but have also decreased therapeutic efficacy. Between January 1990 and December 1992, 41 previously untre ated patients, 65 years with stage 2-4 intermediate- or high-grade NHL were treated with a new therapeutic scheme which included Mitoxantron e, Etoposide, Cyclophosphamide and Prednisone (MiCEP). Twenty-eight pa tients achieved a complete remission, ten patients partial remission ( overall response rate of 93%) and two cases were resistant, The overal l survival was 66% with a median follow-up of 24 months from diagnosis : three patients relapsed after a median period of 7 months. The relap se-free survival was 92% after a median follow-up of 18 months. Blood and other organ toxicity was acceptable and 12% of patients experience d a grade 4 (WHO) neutropenia. In conclusion, MiCEP was effective in i nducing a good remission rate with moderate toxic effects in elderly p atients with intermediate- or high-grade NHL and appears to be a usefu l combination to use in this group of patients.