Abstract:
:In a phase II trial, we evaluated chlorambucil and rituximab (CLB-R) as first-line induction treatment with or without R as maintenance for elderly chronic lymphocytic leukemia (CLL) patients. Treatment consisted of eight 28-day cycles of CLB (8 mg/m(2) /day, days 1-7) and R (day 1 of cycle 3, 375 mg/m(2) ; cycles 4-8, 500 mg/m(2) ). Responders were randomized to 12 8-week doses of R (375 mg/m(2) ) or observation. As per intention-to-treat analysis, 82.4% (95% CI, 74.25-90.46%) of 85 patients achieved an overall response (OR), 16.5% a complete response (CR), 2.4% a CR with incomplete bone marrow recovery. The OR was similar across Binet stages (A 86.4%, B 81.6%, and C 78.6%) and age categories (60-64 years, 92.3%; 65-69, 85.2%; 70-74, 75.0%; ≥75, 81.0%). CLB-R was well tolerated. After a median follow-up of 34.2 months, the median progression-free survival (PFS) was 34.7 months (95% CI, 33.1-39.5). TP53 abnormalities, complex karyotype, and low CD20 gene expression predicted lack of response; SF3B1 mutation and BIRC3 disruption low CR rates. IGHV mutations significantly predicted PFS. R maintenance tended towards a better PFS than observation and was safe and most beneficial for patients in partial response and for unmutated IGHV cases. CLB-R represents a promising option for elderly CLL patients.
journal_name
Am J Hematoljournal_title
American journal of hematologyauthors
Foà R,Del Giudice I,Cuneo A,Del Poeta G,Ciolli S,Di Raimondo F,Lauria F,Cencini E,Rigolin GM,Cortelezzi A,Nobile F,Callea V,Brugiatelli M,Massaia M,Molica S,Trentin L,Rizzi R,Specchia G,Di Serio F,Orsucci L,Ambrosdoi
10.1002/ajh.23668subject
Has Abstractpub_date
2014-05-01 00:00:00pages
480-6issue
5eissn
0361-8609issn
1096-8652journal_volume
89pub_type
杂志文章,随机对照试验abstract::We report a case of T-cell chronic lymphoproliferative disorder (CLPD) that shows neither features of T-cell prolymphocytic leukemia nor disease progression for more than 34 months. Flow cytometric analyses of the lymphocytes revealed high expression of CD4 and CD25. Up-regulation of Foxp3, a master regulatory gene fo...
journal_title:American journal of hematology
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journal_title:American journal of hematology
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