Treatment of aggressive non-Hodgkin's lymphoma in elderly patients with thiotepa, novantrone (mitoxantrone), vincristine, prednisone (TNOP)

The aging of the population and the increased incidence of non-Hodgkin's ly mphoma will result in a large number of elderly patients with this disorder . Newer therapies will be required for this group of patients. This article reports a new therapy for elderly patients with diffuse aggressive non-Hod gkin's lymphoma. Patients were treated with TNOP (thiotepa 20 mg/m(2), mito xantrone (Novantrone) 10 mg/m(2), vincristine (Oncovin) 1 mg/m(2) all on da y 1 and prednisone 60 mg/m(2) on days 1 through 5 of a 21-day course. Twent y-six patients were enrolled on study. The patients' ages ranged from 66 ye ars to 87 years, with a mean age of 75.5 years. Eleven patients had a parti al response (42%) and 4 patients had a complete response (15%) for a total response of 57%. Eighty-one percent of patients survived I year and 54% sur vived for 2 years. The median survival was 26 months. Hematologic and nonhe matologic toxicity was tolerable. We believe that TNOP is an excellent ther apeutic option in this group of elderly patients, particularly in the palli ative setting.