The outcome of chronic lymphocytic leukemia patients who relapsed after fludarabine, cyclophosphamide, and rituximab.
Eur J Haematol
; 90(6): 479-85, 2013 Jun.
Article
em En
| MEDLINE
| ID: mdl-23506191
ABSTRACT
BACKGROUND:
There are minimal data about the efficacy of subsequent therapy in patients with relapse after FCR (fludarabine, cyclophosphamide, and rituximab) chemoimmunotherapy.METHODS:
We retrospectively analyzed the outcomes of 119 patients who relapsed after standard-dose FCR. The patient cohort consisted of patients who relapsed after FCR administered as first-line therapy (Group 1, n = 63) and patients relapsing after FCR administered in second/subsequent line; (Group 2, n = 56).RESULTS:
Basic parameters (age, clinical stage, cytogenetics, molecular genetics) did not differ significantly between these subgroups. Likewise, median progression-free survival (PFS) was not considerably different after FCR (18.6 vs. 14.7 months). Subsequent therapy for relapsed disease included FCR retreatment, R-CHOP, alemtuzumab, or rituximab plus high-dose dexamethasone. Overall response rates for the two groups did not significantly differ (59% vs. 44%). Although PFS after subsequent therapy was relatively short, longer PFS was observed in Group 1 (13.3 vs. 5.9 months; P = 0.01), in patients with response duration ≥ 24 months after previous FCR (13 vs. 6.1 months; P < 0.01), and in patients who achieved complete remission after FCR (10.8 vs. 7.9 months in partial remission; P = 0.01). Newly detected 17p deletions were observed in 5/62 patients, and new p53 mutations in 6/34 FCR-treated patients.CONCLUSION:
Our data indicate that the prognosis of patients who relapse after FCR remains poor regardless of the subsequent treatment regimen.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Leucemia Linfocítica Crônica de Células B
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Protocolos de Quimioterapia Combinada Antineoplásica
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article