Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia.
Fiche publication
Date publication
septembre 2015
Journal
Leukemia & lymphoma
Auteurs
Membres identifiés du Cancéropôle Est :
Pr FEUGIER Pierre, Pr DELMER Alain
Tous les auteurs :
Dartigeas C, Van Den Neste E, Berthou C, Maisonneuve H, Leprêtre S, Dilhuydy MS, Béné MC, Nguyen-Khac F, Letestu R, Cymbalista F, De Guibert S, Aurran T, Laribi K, Vilque JP, Tournilhac O, Delmer A, Feugier P, Cazin B, Michallet AS, Lévy V, Troussard X, Delepine R, Tavernier E, Colombat P, Leblond V
Lien Pubmed
Résumé
Elderly patients with chronic lymphocytic leukemia (CLL) are underrepresented in trials evaluating fludarabine, cyclophosphamide, and rituximab (FCR). We assessed four cycles of FCR with two additional rituximab doses on day 14 of cycles 1 and 2 in 194 untreated CLL patients > 65 years (median age 71.2) without del17p. Four FCR cycles were administered to 90.7% (176/194), with (n = 74) or without (n = 102) dose-delay and/or dose-reduction. A total of 50% grade 3/4 neutropenia occurred after each cycle. Only 6.2% cycles were associated with severe infection. Complete remission (CR) was achieved in 19.7%, and partial remission (PR) in 73.9% of patients. Minimal residual disease (MRD) was negative in 36.7%. Overall survival at 36 months was estimated at 87.4%. Oral FC and dose-dense rituximab is feasible and active in fit elderly CLL patients. However, myelosuppression is significant and frequent dose adaptations are required implying that these results cannot be generalized to unfit or frail elderly CLL.
Référence
Leuk. Lymphoma. 2015 Sep;:1-7