Evaluating abbreviated induction with fludarabine, cyclophosphamide, and dose-dense rituximab in elderly patients with chronic lymphocytic leukemia - Archive ouverte HAL Access content directly
Journal Articles Leukemia & lymphoma Year : 2016

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

Eric van den Neste
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Thérèse Aurran
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Kamel Laribi
Anne-Sophie Michallet
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  • PersonId : 928568
Elsa Tavernier

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
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Dates and versions

hal-01272930 , version 1 (11-02-2016)

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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, 2016, 57 (2), pp.328--334. ⟨10.3109/10428194.2015.1063139⟩. ⟨hal-01272930⟩
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