Response and adverse drug reactions to combination chemotherapy in elderly patients with aggressive non-Hodgkin's lymphoma: comparison of CHOP, COP-BLAM, COP-BLAM III, and THP-COPBLM.

We retrospectively compared therapeutic results and adverse events in 198 elderly patients (> or = 70 yr old) with aggressive non-Hodgkin's lymphoma diagnosed between 1981 and 1995 who underwent CHOP, COP-BLAM, COP-BLAM III, or THP-COPBLM chemotherapy. Complete remission (CR) was achieved in 138 patients (69.7%). The CR rate was 47.0% for CHOP, 76.3% for COP-BLAM, 67.9% for COP-BLAM III, and 74.4% for THP-COPBLM therapy (p = 0.013). The 5-yr survival rate was 37.0% for CHOP, 49.0% for COP-BLAM, and 53.5% for COP-BLAM III. The event-free survival rate showed no significant differences between the four treatments. Adverse events of Grade 3 or worse were commonly anemia or granulocytopenia in patients receiving THP-COPBLM therapy. Cardiac sympathetic dysfunction and cardiac mitochondrial damage were less common with pirarubicin than with doxorubicin. For elderly patients, it is better to select therapy with as few adverse events as possible based on the complications and medical history of the individual patients.