The HOVON68 CLL trial revisited: performance status and comorbidity affect survival in elderly patients with chronic lymphocytic leukemia.

Abstract:

:In the HOVON68 CLL trial, patients 65 to 75 years of age had no survival benefit from the addition of low-dose alemtuzumab to fludarabine and cyclophosphamide (FC) in contrast to younger patients. The reasons are explored in this 5-year trial update using both survival analysis and competing risk analysis on non-CLL-related mortality. Elderly FCA patients died more frequently from causes not related to CLL, and more often related to comorbidity (mostly cardiovascular) than to infection. In a Cox multivariate analysis, del(17p), performance status >0, and comorbidity were associated with a higher non-CLL-related mortality in the elderly independent of the treatment modality. Thus, while the 'fit' elderly with no comorbidity or performance status of 0 might potentially benefit from chemo-immunotherapy with FC, caution is warranted, when considering alemtuzumab treatment in elderly patients with cardiovascular comorbidity.

journal_name

Leuk Lymphoma

journal_title

Leukemia & lymphoma

authors

Vojdeman FJ,Van't Veer MB,Tjønnfjord GE,Itälä-Remes M,Kimby E,Polliack A,Wu KL,Doorduijn JK,Alemayehu WG,Wittebol S,Kozak T,Walewski J,Abrahamse-Testroote MC,van Oers MH,Geisler CH

doi

10.1080/10428194.2016.1213831

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

594-600

issue

3

eissn

1042-8194

issn

1029-2403

journal_volume

58

pub_type

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