Effectiveness of Fludarabine, Idarubicin and Cyclophosphamide (FLUIC) Combination Regimen for Young Patients with Untreated Non-Follicular Low-Grade Non-Hodgkin's Lymphoma

• Published in: Leukemia & lymphoma Vol. 45; no. 9; pp. 1815 - 1819
• Main Authors: Zinzani, Pier Luigi, Pulsoni, Alessandro, Gentilini, Patrizia, Visani, Giuseppe, Perrotti, Alessio, Molinari, Anna Lia, Guardigni, Luciano, Tani, Monica, Villivà, Nicoletta, Stefoni, Vittorio, Alinari, Lapo, Martelli, Maurizio, Bonifazi, Francesca, Pileri, Stefano, Tura, Sante, Baccarani, Michele
• Format: Journal Article
• Language: English
• Published: United States Informa UK Ltd 01.09.2004; Taylor & Francis
• Subjects: Adult; Aged; Aging - physiology; Cyclophosphamide - adverse effects; Cyclophosphamide - therapeutic use; Drug Therapy, Combination; Female; First-line therapy; Fludarabine; Humans; Idarubicin - adverse effects; Idarubicin - therapeutic use; idarubicin and cyclophosphamide; Lymphoma, Non-Hodgkin - drug therapy; Male; Middle Aged; Non-follicular LG-NHL; Treatment Outcome; Vidarabine - adverse effects; Vidarabine - analogs & derivatives; Vidarabine - therapeutic use
• ISSN: 1042-8194; 1029-2403
• DOI: 10.1080/1042819042000219502

In the last years, fludarabine (FLU) alone or in combination with other drugs has been reported to be effective in the treatment of previously untreated low-grade non-Hodgkin's lymphomas (LG-NHL). We report on the therapeutic efficacy and toxicity of a combination of FLU, idarubicin and cyclophosphamide (FLUIC regimen) in untreated non-follicular LG-NHL. We administered a three-drug combination of FLU (25 mg/m2 i.v. on days 1 to 3), idarubicin (14 mg/m2 i.v. on day 1) and cyclophosphamide (200 mg/m2 i.v. on days 1 to 3) to treat 41 young, previously untreated patients with non-follicular LG-NHL. Chemotherapy was repeated every 4 weeks for a total of 6 cycles. Among 41 patients, 24 (59%) were diagnosed with small lymphocytic, 10 (24%) with immnocytoma, and 7 (17%) with marginal zone subtypes. Nineteen (46%) patients achieved complete response (CR) and 21 (51%) partial response, while the remaining 1 (3%) showed no benefit from the treatment. With respect to histology, we observed CR rates of 38% for the small lymphocytic subtype, 40% for the immunocytoma subtype, and 86% for the marginal zone subtype. Estimated 42-month overall survival and relapse-free survival rates were 64% and 100%, respectively. Hematologic grade 3-4 toxicity was seen in 9 (22%) patients; no opportunistic infection or death was associated with administration of the FLUIC regimen. These preliminary data suggest that FLUIC is a very active, well-tolerated regimen for young, untreated patients with advanced non-follicular LG-NHL.