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CASE REPORT article

Front. Med.

Sec. Hematology

Volume 12 - 2025 | doi: 10.3389/fmed.2025.1629168

This article is part of the Research TopicAging and Oncology: Molecular Insights and Therapeutic AdvancesView all 4 articles

Mitoxantrone hydrochloride liposome-based chemotherapy plus rituximab in elderly patients older than 80 years with diffuse large B-cell lymphoma: case report and review of the literature

Provisionally accepted
Jin-Ping  PiJin-Ping Pi1Ying  LiuYing Liu2Jun  JinJun Jin1Wei  ZhangWei Zhang1Xiao-Hui  HeXiao-Hui He3*
  • 1Beijing Chao yang District San huan Cancer Hospital, Beijing, China
  • 2Chinese Academy of Medical Sciences, Beijing, China
  • 3Center for National Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

The final, formatted version of the article will be published soon.

Background: Treating diffuse large B-cell lymphoma (DLBCL) in patients over 80 years of age remains a significant clinical challenge due to the unfavorable biology of the disease, worse baseline health status (such as cardiac dysfunction), and the toxicities associated with cytotoxic chemotherapy. In this context, attenuated regimens may provide a more favorable risk-benefit profile for elderly DLBCL patients. Mitoxantrone hydrochloride liposome, a liposomal formulation of the synthetic anthracycline anticancer drug, offers several inherent advantages, including reduced cardiotoxicity and targeted delivery to tumor tissue, leading to improved antitumor efficacy and minimized systemic toxicity. Case presentation: Therefore, we report a case-series study evaluating the efficacy and safety of mitoxantrone hydrochloride liposome-based chemotherapy plus rituximab in 3 patients with DLBCL aged over 80 years. Two patients achieved complete metabolic remission (CMR) after treatment with mitoxantrone hydrochloride liposome-based regimens, while 1 attained CMR after receiving this first-line chemotherapy regimen combined with local radiotherapy. Additionally, the safety profile was acceptable and manageable. Conclusion: These cases suggest that mitoxantrone hydrochloride liposome-based chemotherapy may be effective (all 3 cases achieved CMR) in very elderly DLBCL patients, warranting further evaluation in larger cohorts.

Keywords: Diffuse large B-cell lymphoma, case report, Mitoxantrone hydrochloride liposome, Cardiac involvement, older patients

Received: 15 May 2025; Accepted: 04 Aug 2025.

Copyright: © 2025 Pi, Liu, Jin, Zhang and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xiao-Hui He, Center for National Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

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