Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia

Caroline Dartigeas; Eric Van den Neste; Christian Berthou; Hervé Maisonneuve; Stéphane Leprêtre; Marie-Sarah Dilhuydy; Marie-Christine Béné; Florence Nguyen-Khac; Rémi Letestu; Florence Cymbalista; Sophie de Guibert; Thérèse Aurran; Kamel Laribi; Jean-Pierre Vilque; Olivier Tournilhac; Alain Delmer; Pierre Feugier; Bruno Cazin; Anne-Sophie Michallet; Vincent Levy; Xavier Troussard; Roselyne Delépine; Elsa Tavernier; Philippe Colombat; Véronique Leblond

Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia

Caroline Dartigeas ¹ Eric Van den Neste Christian Berthou ^{2, 3} Hervé Maisonneuve ⁴ Stéphane Leprêtre ⁵ Marie-Sarah Dilhuydy ⁶ Marie-Christine Béné ⁷ Florence Nguyen-Khac ^{8, 9} Rémi Letestu ¹⁰ Florence Cymbalista ¹⁰ Sophie de Guibert ^{11, 12} Thérèse Aurran Kamel Laribi Jean-Pierre Vilque ¹³ Olivier Tournilhac ^{14, 15} Alain Delmer ¹⁶ Pierre Feugier ^{17, 18} Bruno Cazin ¹⁹ Anne-Sophie Michallet ²⁰ Vincent Levy ²¹ Xavier Troussard ^{22, 23} Roselyne Delépine ²⁴ Elsa Tavernier Philippe Colombat ²⁵ Véronique Leblond ⁹

1 N2C - Nutrition, croissance et cancer (U 1069)

2 CHU-Brest-Hemato - CHRU Brest - Service d'Hématologie

3 EA2216 - Immunologie et Pathologie

4 Service d'hématologie

5 GPL - Groupe d'étude des proliférations lymphoïdes

6 Service des maladies du sang

7 CHU Nantes - Centre hospitalier universitaire de Nantes

8 CRC - Centre de Recherche des Cordeliers

9 Service d'hématologie biologique [CHU Pitié-Salpêtrière]

10 ASIH - Adaptateurs de signalisation en hématologie

11 CHU Pontchaillou [Rennes]

12 CIC - Centre d'Investigation Clinique [Rennes]

13 CRLC François Baclesse - Centre Régional de Lutte contre le Cancer François Baclesse

14 Service d'Hématologie Clinique Adulte et de Thérapie Cellulaire

15 EA7283, CIC501

16 Service d'hématologie et immunologie pédiatrique

17 Service d'Hématologie [CHRU Nancy]

18 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux

19 Service des maladies du sang

20 Service d'Hematologie

21 AP HP, Clin Res Unit

22 Francim : Réseau français des registres des cancers

23 Registre des hémopathies malignes de Basse-Normandie

24 Service d'hématologie [Tours]

25 Service d'Hématologie

Abstract : 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 \textgreater 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

Document type :

Journal articles

Domain :

Life Sciences [q-bio]

Complete list of metadatas

https://hal-univ-rennes1.archives-ouvertes.fr/hal-01272930
Contributor : Nelly Brenner <>
Submitted on : Thursday, February 11, 2016 - 3:33:53 PM
Last modification on : Monday, May 27, 2019 - 10:11:47 AM

Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia

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Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia

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