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Low-dose oral fludarabine plus cyclophosphamide in elderly patients with untreated and relapsed or refractory chronic lymphocytic Leukaemia

Low-dose oral fludarabine plus cyclophosphamide in elderly patients with untreated and relapsed or refractory chronic lymphocytic Leukaemia
Low-dose oral fludarabine plus cyclophosphamide in elderly patients with untreated and relapsed or refractory chronic lymphocytic Leukaemia
Fludarabine plus cyclophosphamide (FC) at conventional doses is an effective treatment for chronic lymphocytic leukaemia (CLL). However, FC at standard doses may give hematological and non-hematological toxicity, predominantly in the elderly. Intravenous or oral low-dose FC regimens remain highly effective in elderly patients with Low-Grade Lymphomas other than CLL and are well tolerated. We tested efficacy and toxicity of oral FC at reduced doses in 26 elderly patients (median 71 years) with previously untreated (UT-CLL, n = 14) or relapsed/refractory CLL (R-CLL, n = 12), unfit for conventional treatments. Twentyfour-of-26 (92%) patients (14/14, 100% UT-CLL; 10/12, 83.5% R-CLL) obtained a response, with 12/26 (46%) complete responses (9/14, 64.2% in UT-CLL; 3/12, 25% in R-CLL). Non-hematological toxicity was mild and myelosuppression was documented in 8/26 (31%) patients (4/14, 28% UT-CLL; 4/12, 33% R-CLL). With a median follow-up of 24 months, median event-free survival was 48 months with no differences between UT-CLL and R-CLL and all responders were alive. Low-dose oral FC treatment showed good efficacy in both untreated and refractory/relapsed CLL. The treatment is useful in elderly patients who cannot benefit of more aggressive schedules and is easy to administer on an outpatient basis.
oral fludarabine, cyclophosphamide, low dose, elderly, chronic lymphocytic leukaemia
0278-0232
247-251
Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Fabbri, Alberto
01268e1d-6b5a-44e0-9702-a25caa971f59
Lenoci, Mariapia
e7a3fdb7-9263-45b1-b627-9d85c349abca
Sozzi, Elisa
e811ff23-6fe9-47ec-b052-fe8d34d1e36b
Gozzetti, Alessandro
18591c75-cbee-444e-972e-b13dce8340e7
Tassi, Maristella
3ff312c2-d76f-4887-80a7-9219465064fb
Raspadori, Donatella
185f6866-6d10-4f86-9add-72938cea80b3
Lauria, Francesco
f01f163b-abcb-4aad-b952-f4356692f519
Forconi, Francesco
ce9ed873-58cf-4876-bf3a-9ba1d163edc8
Fabbri, Alberto
01268e1d-6b5a-44e0-9702-a25caa971f59
Lenoci, Mariapia
e7a3fdb7-9263-45b1-b627-9d85c349abca
Sozzi, Elisa
e811ff23-6fe9-47ec-b052-fe8d34d1e36b
Gozzetti, Alessandro
18591c75-cbee-444e-972e-b13dce8340e7
Tassi, Maristella
3ff312c2-d76f-4887-80a7-9219465064fb
Raspadori, Donatella
185f6866-6d10-4f86-9add-72938cea80b3
Lauria, Francesco
f01f163b-abcb-4aad-b952-f4356692f519

Forconi, Francesco, Fabbri, Alberto, Lenoci, Mariapia, Sozzi, Elisa, Gozzetti, Alessandro, Tassi, Maristella, Raspadori, Donatella and Lauria, Francesco (2008) Low-dose oral fludarabine plus cyclophosphamide in elderly patients with untreated and relapsed or refractory chronic lymphocytic Leukaemia. Hematological Oncology, 26 (4), 247-251. (doi:10.1002/hon.868). (PMID:18642397)

Record type: Article

Abstract

Fludarabine plus cyclophosphamide (FC) at conventional doses is an effective treatment for chronic lymphocytic leukaemia (CLL). However, FC at standard doses may give hematological and non-hematological toxicity, predominantly in the elderly. Intravenous or oral low-dose FC regimens remain highly effective in elderly patients with Low-Grade Lymphomas other than CLL and are well tolerated. We tested efficacy and toxicity of oral FC at reduced doses in 26 elderly patients (median 71 years) with previously untreated (UT-CLL, n = 14) or relapsed/refractory CLL (R-CLL, n = 12), unfit for conventional treatments. Twentyfour-of-26 (92%) patients (14/14, 100% UT-CLL; 10/12, 83.5% R-CLL) obtained a response, with 12/26 (46%) complete responses (9/14, 64.2% in UT-CLL; 3/12, 25% in R-CLL). Non-hematological toxicity was mild and myelosuppression was documented in 8/26 (31%) patients (4/14, 28% UT-CLL; 4/12, 33% R-CLL). With a median follow-up of 24 months, median event-free survival was 48 months with no differences between UT-CLL and R-CLL and all responders were alive. Low-dose oral FC treatment showed good efficacy in both untreated and refractory/relapsed CLL. The treatment is useful in elderly patients who cannot benefit of more aggressive schedules and is easy to administer on an outpatient basis.

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More information

Published date: December 2008
Keywords: oral fludarabine, cyclophosphamide, low dose, elderly, chronic lymphocytic leukaemia
Organisations: Cancer Sciences

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Local EPrints ID: 358157
URI: https://eprints.soton.ac.uk/id/eprint/358157
ISSN: 0278-0232
PURE UUID: 5c2a1f10-ea65-4065-b679-0199328ab6a2

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Date deposited: 08 Oct 2013 13:40
Last modified: 18 Jul 2017 03:31

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Contributors

Author: Alberto Fabbri
Author: Mariapia Lenoci
Author: Elisa Sozzi
Author: Alessandro Gozzetti
Author: Maristella Tassi
Author: Donatella Raspadori
Author: Francesco Lauria

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