Doxorubicin represents the mainstay in the upfront treatment of diffuse large B-cell lymphoma (DLBCL) patients. However, its administration is sometimes hampered by the coexistence of former comorbidities/cardiac issues, especially in the elderly population. Liposome encapsulated drug delivery systems have been adopted to reduce the exposure of normal tissues to the drug, both in solid cancers and lymphomas. Despite claims for lower toxicity, the efficacy of non-pegylated liposome doxorubicin (NPLD) in DLBCL, as compared to standard doxorubicin, has never been established. We systematically reviewed relevant literature of NPLD in lymphoma treatment. Adjusting for age/comorbidities, our metanalysis revealed that the use of combinations including NPLD (R-COMP) were non-inferior in terms of response, overall and progression-free survival to the standard of care (R-CHOP) in overlapping series of DLBCL patients. R-COMP may represent a safe and active option for elderly patients with DLBCL, or for those with some extent of cardiac impairment at baseline.

阿霉素是弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者前期治疗的中流砥柱。然而，它的管理有时会受到既往合并症/心脏问题共存的阻碍，尤其是在老年人群中。脂质体封装的药物递送系统已被用于减少正常组织对药物的暴露，无论是在实体癌还是淋巴瘤中。尽管声称毒性较低，但与标准阿霉素相比，非聚乙二醇化脂质体阿霉素 (NPLD) 在 DLBCL 中的疗效从未得到证实。我们系统地回顾了 NPLD 在淋巴瘤治疗中的相关文献。调整年龄/合并症后，我们的荟萃分析显示，使用包括 NPLD (R-COMP) 在内的组合在反应方面不劣，在重叠系列 DLBCL 患者中达到标准护理 (R-CHOP) 的总体和无进展生存率。对于患有 DLBCL 的老年患者或基线时有一定程度心脏损伤的患者，R-COMP 可能代表一种安全且积极的选择。