Efficacy and toxicity of liposomal daunorubicin (daunoxome) in non-Hodgkin's lymphomas

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 larg e B-cell lymphoma (n=11), follicular lymphoma, predominantly large cells (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/m(2) with an increase u p to 100 mg/m(2) in case of slow response and good tolerance. The other dru gs were used in standard doses. Results. 6 patients achieved complete remission (43%) and 5 patients - part ial response (36%), the overall response was 79%. Three patients did not re spond to therapy and died. Six patients are still in complete and two in pa rtial remission, median follow-up being 22 months. The rest 3 patients were treated with other modalities, one of them died of infection. As to compli cations that might be related to daunoxome, there was myleodepression (6% o f profound neutropenia <1000 microl). No patients had deterioration of the left ventricular ejection fraction (ultrasound measurements) or clinical si gns of congestive heart failure (median follow-up for 10 patients was 22 mo nths) including those in whom high cumulative doses were used (640-840 mg/m (2)). 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 stu dies are needed for determination of efficacy and maximal tolerated dose of daunoxome in combination with other drugs and irradiation, of longterm sid e effects. this drug may be beneficial for elderly patients.