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. 2011 Oct 28;3(3s):e4.
doi: 10.4081/hr.2011.s3.e4.

Anthracyclines: a cornerstone in the management of non-Hodgkin's lymphoma

Stefano Luminari  1 , Antonella Montanini, Massimo Federico
Affiliations

Anthracyclines: a cornerstone in the management of non-Hodgkin's lymphoma

Stefano Luminari et al. Hematol Rep. .

Abstract

Since anthracyclines were introduced in the treatment of non-Hodgkin's lymphoma in the late 1960s, they have been acknowledged as a cornerstone in the management of the disease and, in particular, of aggressive lymphomas. The high efficacy of anthracycline-containing regimens must, however, be balanced against the drug-related toxicity, which mainly affects the cardiovascular system and represents a major concern for clinicians, especially in the treatment of elderly patients. Patients' outcomes could be further improved, particularly for those at high risk of cardiotoxicity, by substituting liposomal doxorubicin for conventional doxorubicin. This approach has already been tested and shown to be effective in several cancers, especially in different subsets of patients with diffuse large B-cell lymphoma. The use of liposomal doxorubicin in combination regimens for other conditions, such as follicular lymphoma and splenic marginal zone lymphoma, is also under investigation, and early results are promising.

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Conflict of interest statement

Conflict of interest: MF has received honoraria from Cephalon; SL and AM report no conflicts of interest.

Figures

Figure 1
Figure 1
Kaplan-Meier analysis of the probability of (A) overall survival, (B) failure-free survival, and (C) progression-free survival in elderly patients receiving rituximab, cyclophosphamide, non-pegylated liposomal doxorubicin, vincristine, and prednisone (R-COMP) chemotherapy for diffuse large B-cell lymphoma (results from the EUR018 trial). From Luminari S et al. Nonpegylated liposomal doxorubicin (Myocet™) combination (R-COMP) chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL): results from the phase II EUR018 trial. Ann Oncol 2010;21:1492-9. Reprinted with permission from Oxford University Press.
Figure 2
Figure 2
Left ventricular ejection fraction (LVEF) from baseline to end of treatment in elderly patients receiving rituximab, cyclophosphamide, non-pegylated liposomal doxorubicin, vincristine, and prednisone (R-COMP) chemotherapy for diffuse large B-cell lymphoma (results from the EUR018 trial). From Luminari S et al. Nonpegylated liposomal doxorubicin (MyocetTM) combination (R-COMP) chemotherapy in elderly patients with diffuse large B-cell lymphoma (DLBCL): results from the phase II EUR018 trial. Ann Oncol 2010;21:1492-9. Reprinted with permission from Oxford University Press.
Figure 3
Figure 3
Overall survival (OS) of patients with follicular lymphoma who had received chemotherapy regimens containing doxorubicin and those who had not received this anthracycline. Reprinted with permission from Rigacci L et al. The role of anthracyclines in combination chemotherapy for the treatment of follicular lymphoma: retrospective study of the Intergruppo Italiano Linfomi on 761 cases. Leuk Lymphoma 2003;44:1911-17.
See this image and copyright information in PMC

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