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Lymphoma

Lenalidomide can be safely combined with R-CHOP (R2CHOP) in the initial chemotherapy for aggressive B-cell lymphomas: phase I study

Leukemia volume 25, pages 1877–1881 (2011)Cite this article

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Abstract

Lenalidomide was shown to have significant single-agent activity in relapsed aggressive non-Hodgkin's lymphoma (NHL). We conducted a phase I trial to establish the maximum tolerated dose of lenalidomide that could be combined with R-CHOP (rituximab–cyclophosphamide, doxorubicin, vincristine, and prednisone). Eligible patients were adults with newly diagnosed, untreated CD20 positive diffuse large cell or follicular grade III NHL. Patients received oral lenalidomide on days 1–10 with standard dose R-CHOP every 21 days. All patients received pegfilgrastim on day 2 of the cycle and aspirin prophylaxis. The lenalidomide dose levels tested were 15, 20 and 25 mg. A total of 24 patients were enrolled. The median age was 65 (35–82) years and 54% were over 60 years. Three patients received 15 mg, 3 received 20 mg and 18 received 25 mg of lenalidomide. No dose limiting toxicity was found, and 25 mg on days 1–10 is the recommended dose for phase II. The incidence of grade IV neutropenia and thrombocytopenia was 67% and 21%, respectively. Febrile neutropenia was rare (4%) and there were no toxic deaths. The overall response rate was 100% with a complete response rate of 77%. Lenalidomide at the dose of 25 mg/day administered on days 1 to 10 of 21-day cycle can be safely combined with R-CHOP in the initial chemotherapy of aggressive B-cell lymphoma.

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Authors and Affiliations

  1. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    G S Nowakowski, T M Habermann, D J Inwards, I N Micallef, P B Johnston, L F Porrata, S M Ansell, R R Klebig & T E Witzig

  2. Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    B LaPlant

  3. Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL, USA

    C E Rivera

  4. Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA

    W R Macon

  5. Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ, USA

    C B Reeder

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  1. G S Nowakowski
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Correspondence to G S Nowakowski or T E Witzig.

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Nowakowski, G., LaPlant, B., Habermann, T. et al. Lenalidomide can be safely combined with R-CHOP (R2CHOP) in the initial chemotherapy for aggressive B-cell lymphomas: phase I study. Leukemia 25, 1877–1881 (2011). https://doi.org/10.1038/leu.2011.165

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