Rituximab plus dose-reduced cyclophosphamide, mitoxantrone, vincristine, and prednisolone are effective in elderly patients with diffuse large B-cell lymphoma of the thyroid.

Background: Primary thyroid lymphoma is a rare disease. Although many reports have dealt with surgery followed by chemotherapy or radiation as well as combined chemoradiation, little is known about the value of immunochemotherapy alone. We present the results of systemic treatment using rituximab (R) plus dose reduced mitoxantrone, cyclophosphamide, vincristine, and prednisolone in three elderly patients with primary diffuse large B-cell lymphoma (DLBCL) of the thyroid. Patients and methods: Three patients aged between 86 and 93 years were found to have DLBCL of the thyroid. Lymphoma was locally advanced and deemed unresectable in one patient, whereas the remaining two patients were judged unfit for surgery. All patients were given systemic therapy with R 375 mg/m2 on day 1, mitoxantrone 8 mg intravenously, cyclophosphamide 750 mg intravenously, and vincristine 1 mg (all given on day 2), along with 100 mg oral prednisolone on days 1–5. Results: Two patients were given 6 cycles and one patient was given 8 ...