WEEKLY ADMINISTRATION OF VINCRISTINE, CYCLOPHOSPHAMIDE, MITOXANTRONE AND BLEOMYCIN (VEMB) IN THE TREATMENT OF ELDERLY AGGRESSIVE NON-HODGKINS-LYMPHOMA

Background and Objective. Aim of the study was to assess the efficacy of VEMB, a short-lasting therapeutic regimen (50 days) which alternate s two myelotoxic drugs (cyclophosphamide and mitoxantrone) every week with two less hematologically toxic drugs (vincristine and bleomycin) in the treatment of aggressive NHL in the elderly (over 70). Design an d Methods. Between November 1994 and March 1996, 37 patients aged more than 70 years, with highly or moderately malignant NHL (according to the Working Formulation) have been enrolled into the study. The stage of the disease ranged between II and IV according to Ann Arbor. Mean a ge was 77 years; 14 patients (38%) had stage IV; 19 patients (51%) had LDH higher than normal; 26 patients (70%) had extranodal and 9 patien ts (24%) had bulky disease at time of diagnosis. Results. Sixty-two pe rcent of patients achieved a complete and 22% a partial remission. Non -responders amounted to 5%. Four patients (11%) died during the therap y; Nine patients (24%) experienced grade III-IV neutropenia. The most frequently observed event was mild neurotoxicity (43% of cases). The o verall survival rate at 30 months was 55%. DFS at 24 months was 66%. I nterpretation and Conclusions. VEMB is a therapeutic regimen whose eff icacy is comparable to that of the other derived MACOP-B therapeutic r egimens used in the elderly NHL. It has proved to have a good feasibil ity, though the number of toxic deaths should not be neglected. (C) 19 98, Ferrata Storti Foundation.