Front-Line Therapy for Elderly Chronic Lymphocytic Leukemia Patients: Bendamustine Plus Rituximab or Chlorambucil Plus Rituximab? Real-Life Retrospective Multicenter Study in the Lazio Region

Luca Laurenti, Francesco Autore, Idanna Innocenti, Francesco Corrente, Alberto Fresa, Eliana Conte, Giovanni Cimino, Michele Montanaro, Maria Ilaria Del Principe, Serena Rosati, Paolo Falcucci, Esmeralda Conte, Maria Assunta Limongiello, Daniela Renzi, Alessandro Andriani, Francesco Pisani, Giuseppe Cimino, Agostino Tafuri, Marco Montanaro, Francesca Romana MauroGiovanni Del Poeta

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Previous studies investigated the efficacy and the safety of bendamustine (B) vs. chlorambucil (Chl) associated with rituximab (R) in fludarabine-ineligible patients with treated and untreated chronic lymphocytic leukemia (CLL). We conducted a retrospective multicenter study in the Lazio region to further evaluate and compare the efficacy and the toxicity of Chl-R and B-R regimen in CLL patients over the age of 65. We enrolled 192 untreated CLL patients: 111 treated with B-R and 81 with Chl-R. The overall response rates (ORR; 93.6% in B-R and 86.5% in Chl-R) were not statistically different between the two groups, such as progression-free survival (PFS), time to retreatment (TTR), and overall survival (OS). The B-R group showed a higher hematological (p = 0.007) and extra-hematological (p = 0.008) toxicity. When comparing the toxicities according to age, we noted that the extra-hematological toxicity was higher in patients over the age of 75 who were treated with B-R than those treated with Chl-R (p = 0.03). This retrospective study confirms the feasibility of B-R and Chl-R in elderly untreated CLL patients. Currently, patients who are over 75 and unfit are usually treated with Chl-R. This scheme allows achieving the same ORR, PFS, TTR, and OS when compared with B-R because of hematological and extra-hematological toxicities due to B, in which a greater dose reduction has been shown in comparison to Chl.
Lingua originaleEnglish
pagine (da-a)1-7
Numero di pagine7
RivistaFrontiers in Oncology
Volume10
DOI
Stato di pubblicazionePubblicato - 2020

Keywords

  • bendamustine
  • chemoimmunotherapy
  • chlorambucil
  • chronic lymphocytic leukemia
  • rituximab

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