MITOXANTRONE, PREDNIMUSTINE, AND VINCRISTINE FOR ELDERLY PATIENTS WITH AGGRESSIVE NON-HODGKINS-LYMPHOMA

Elderly patients with intermediate- or high-grade non-Hodgkin's lympho ma have a worse outcome than those who are younger than 60 years. It h as been shown that aggressive combination chemotherapy is poorly toler ated in older patients resulting in a subsequent decrease in dose inte nsity. A phase II trial was conducted with mitoxantrone, prednimustine , and vincristine (NSO) in this group of patients. NSO consists of mit oxantrone 12 mg/M-2 intravenously on day one, vincristine 1.4 mg/M-2 i ntravenously on day 1 (maximum dose of two mg), and prednimustine 100 mg/M-2 orally once a day for four days. NSO was repeated every 21 days . Thirty-six patients were able to be evaluated. There were 18 males a nd 18 females with the median age of 71 (range 60-85). NSO was well to lerated and nonhematological toxicities were uncommon. More than 80% o f the patients received 90% or greater of the intended dose. The compl ete response rate was 60.6% and partial response was 21.8%. At 60 mont hs the Kaplan-Meier estimate of progression-free survival was 47.9% (s tandard error 8.6%) and actual survival was 40.6% (standard error 8.8% ), There were no differences in outcome between those with performance status (PS) of zero or one and those with PS >1. NSO is well tolerate d by elderly patients including those with PS > 1, These results compa re favorably with other combinations in elderly patients with aggressi ve non-Hodgkin's lymphoma. Am. J. Hematol, 59:156-160, 1998. (C) 1998 Wiley-Liss, Inc.