Rituximab-including combined modality treatment for primary thyroid lymphoma

An effective regimen for elderly patients

Natsuko Watanabe, Hiroto Narimatsu, Jaeduk Yoshimura Noh, Yo Kunii, Koji Mukasa, Masako Matsumoto, Miho Suzuki, Kenichi Sekiya, Hidemi Ohye, Ai Yoshihara, Kenji Iwaku, Sachiko Kobayashi, Kaori Kameyama, Kazuhiko Kobayashi, Yoshitaka Nishikawa, Masahiro Kami, Kiminori Sugino, Koichi Ito

Research output: Contribution to journalArticle

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Abstract

Background: Primary thyroid lymphoma (PTL) develops mostly in middle-aged and older females. However, the optimal treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL), which accounts for most PTL cases, is unclear. Rituximab is a promising drug that, in combination with traditional combination therapy, has demonstrated an increased antitumor effect without a substantial increase in toxicity. In this study, treatment outcomes of elderly patients with thyroid DLBCL who underwent rituximab-including combination therapy were analyzed. Method: Between January 2005 and December 2011, 43 patients 60 years of age or older (median 71 years, range 60-80 years) were diagnosed as having stage IE (n = 12) or stage IIE (n = 31) DLBCL, and three courses of R-CHOP therapy (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m 2, and prednisolone 100 mg/body) and involved field irradiation were planned. Treatment outcomes of these patients were retrospectively reviewed. Results: Two patients terminated the treatment because of interstitial pneumonia during R-CHOP therapy. Only one patient showed treatment resistance and the regimen was changed; 42 patients (98%) responded to the treatment. Five-year overall survival and event-free survival were 87% (95% confidence interval [95% CI], 64-96%) and 74% (95% CI, 50-89%), respectively. Conclusion: The results of the present study indicate that rituximab-including combination therapy was effective for elderly patients with thyroid DLBCL. A multicenter, long-term observational study is needed to confirm this, and additional refinement of the treatment protocol is required to optimize the antitumor effect.

Original languageEnglish
Pages (from-to)994-999
Number of pages6
JournalThyroid
Volume24
Issue number6
DOIs
Publication statusPublished - 2014 Jun 1

Fingerprint

Lymphoma
Thyroid Gland
Lymphoma, Large B-Cell, Diffuse
Therapeutics
Confidence Intervals
Rituximab
Interstitial Lung Diseases
Vincristine
Drug Combinations
Clinical Protocols
Prednisolone
Doxorubicin
Cyclophosphamide
Disease-Free Survival
Observational Studies
Survival

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Medicine(all)

Cite this

Watanabe, N., Narimatsu, H., Noh, J. Y., Kunii, Y., Mukasa, K., Matsumoto, M., ... Ito, K. (2014). Rituximab-including combined modality treatment for primary thyroid lymphoma: An effective regimen for elderly patients. Thyroid, 24(6), 994-999. https://doi.org/10.1089/thy.2013.0523

Rituximab-including combined modality treatment for primary thyroid lymphoma : An effective regimen for elderly patients. / Watanabe, Natsuko; Narimatsu, Hiroto; Noh, Jaeduk Yoshimura; Kunii, Yo; Mukasa, Koji; Matsumoto, Masako; Suzuki, Miho; Sekiya, Kenichi; Ohye, Hidemi; Yoshihara, Ai; Iwaku, Kenji; Kobayashi, Sachiko; Kameyama, Kaori; Kobayashi, Kazuhiko; Nishikawa, Yoshitaka; Kami, Masahiro; Sugino, Kiminori; Ito, Koichi.

In: Thyroid, Vol. 24, No. 6, 01.06.2014, p. 994-999.

Research output: Contribution to journalArticle

Watanabe, N, Narimatsu, H, Noh, JY, Kunii, Y, Mukasa, K, Matsumoto, M, Suzuki, M, Sekiya, K, Ohye, H, Yoshihara, A, Iwaku, K, Kobayashi, S, Kameyama, K, Kobayashi, K, Nishikawa, Y, Kami, M, Sugino, K & Ito, K 2014, 'Rituximab-including combined modality treatment for primary thyroid lymphoma: An effective regimen for elderly patients', Thyroid, vol. 24, no. 6, pp. 994-999. https://doi.org/10.1089/thy.2013.0523
Watanabe, Natsuko ; Narimatsu, Hiroto ; Noh, Jaeduk Yoshimura ; Kunii, Yo ; Mukasa, Koji ; Matsumoto, Masako ; Suzuki, Miho ; Sekiya, Kenichi ; Ohye, Hidemi ; Yoshihara, Ai ; Iwaku, Kenji ; Kobayashi, Sachiko ; Kameyama, Kaori ; Kobayashi, Kazuhiko ; Nishikawa, Yoshitaka ; Kami, Masahiro ; Sugino, Kiminori ; Ito, Koichi. / Rituximab-including combined modality treatment for primary thyroid lymphoma : An effective regimen for elderly patients. In: Thyroid. 2014 ; Vol. 24, No. 6. pp. 994-999.
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abstract = "Background: Primary thyroid lymphoma (PTL) develops mostly in middle-aged and older females. However, the optimal treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL), which accounts for most PTL cases, is unclear. Rituximab is a promising drug that, in combination with traditional combination therapy, has demonstrated an increased antitumor effect without a substantial increase in toxicity. In this study, treatment outcomes of elderly patients with thyroid DLBCL who underwent rituximab-including combination therapy were analyzed. Method: Between January 2005 and December 2011, 43 patients 60 years of age or older (median 71 years, range 60-80 years) were diagnosed as having stage IE (n = 12) or stage IIE (n = 31) DLBCL, and three courses of R-CHOP therapy (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m 2, and prednisolone 100 mg/body) and involved field irradiation were planned. Treatment outcomes of these patients were retrospectively reviewed. Results: Two patients terminated the treatment because of interstitial pneumonia during R-CHOP therapy. Only one patient showed treatment resistance and the regimen was changed; 42 patients (98{\%}) responded to the treatment. Five-year overall survival and event-free survival were 87{\%} (95{\%} confidence interval [95{\%} CI], 64-96{\%}) and 74{\%} (95{\%} CI, 50-89{\%}), respectively. Conclusion: The results of the present study indicate that rituximab-including combination therapy was effective for elderly patients with thyroid DLBCL. A multicenter, long-term observational study is needed to confirm this, and additional refinement of the treatment protocol is required to optimize the antitumor effect.",
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AU - Watanabe, Natsuko

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AU - Noh, Jaeduk Yoshimura

AU - Kunii, Yo

AU - Mukasa, Koji

AU - Matsumoto, Masako

AU - Suzuki, Miho

AU - Sekiya, Kenichi

AU - Ohye, Hidemi

AU - Yoshihara, Ai

AU - Iwaku, Kenji

AU - Kobayashi, Sachiko

AU - Kameyama, Kaori

AU - Kobayashi, Kazuhiko

AU - Nishikawa, Yoshitaka

AU - Kami, Masahiro

AU - Sugino, Kiminori

AU - Ito, Koichi

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N2 - Background: Primary thyroid lymphoma (PTL) develops mostly in middle-aged and older females. However, the optimal treatment for elderly patients with diffuse large B-cell lymphoma (DLBCL), which accounts for most PTL cases, is unclear. Rituximab is a promising drug that, in combination with traditional combination therapy, has demonstrated an increased antitumor effect without a substantial increase in toxicity. In this study, treatment outcomes of elderly patients with thyroid DLBCL who underwent rituximab-including combination therapy were analyzed. Method: Between January 2005 and December 2011, 43 patients 60 years of age or older (median 71 years, range 60-80 years) were diagnosed as having stage IE (n = 12) or stage IIE (n = 31) DLBCL, and three courses of R-CHOP therapy (rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, adriamycin 40 mg/m2, vincristine 1.4 mg/m 2, and prednisolone 100 mg/body) and involved field irradiation were planned. Treatment outcomes of these patients were retrospectively reviewed. Results: Two patients terminated the treatment because of interstitial pneumonia during R-CHOP therapy. Only one patient showed treatment resistance and the regimen was changed; 42 patients (98%) responded to the treatment. Five-year overall survival and event-free survival were 87% (95% confidence interval [95% CI], 64-96%) and 74% (95% CI, 50-89%), respectively. Conclusion: The results of the present study indicate that rituximab-including combination therapy was effective for elderly patients with thyroid DLBCL. A multicenter, long-term observational study is needed to confirm this, and additional refinement of the treatment protocol is required to optimize the antitumor effect.

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