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 Department of Clinical Haematology, Institute of Cancerology and Hematology
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
10 ASIH - Adaptateurs de signalisation en hématologie
11 CHU Pontchaillou [Rennes]
12 CIC - Centre d'Investigation Clinique [Rennes]
13 Centre 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
Type de document :
Article dans une revue
Leukemia & lymphoma, Taylor & Francis, 2016, 57 (2), pp.328--334. 〈10.3109/10428194.2015.1063139〉
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https://hal-univ-rennes1.archives-ouvertes.fr/hal-01272930
Contributeur : Nelly Brenner <>
Soumis le : jeudi 11 février 2016 - 15:33:53
Dernière modification le : vendredi 4 janvier 2019 - 17:33:32

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UNIV-BREST | HCL | UPMC | CORDELIERS | UNIV-PARIS5 | IMMUNO | CIC203 | CIC | COMUE-NORMANDIE | PRES_CLERMONT | UNIV-PARIS13 | BIOSIT | UR1-UFR-SVE | PSL | USPC | UNIV-LORRAINE | ASIH | CHLS | UNIV-RENNES | UNIROUEN | NGERE-UL | SORBONNE-UNIVERSITE

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Caroline Dartigeas, Eric Van den Neste, Christian Berthou, Hervé Maisonneuve, Stéphane Leprêtre, et al.. Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia. Leukemia & lymphoma, Taylor & Francis, 2016, 57 (2), pp.328--334. 〈10.3109/10428194.2015.1063139〉. 〈hal-01272930〉

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