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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
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 f...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298101/ https://www.ncbi.nlm.nih.gov/pubmed/32587827 http://dx.doi.org/10.3389/fonc.2020.00848 |
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author | Autore, Francesco Innocenti, Idanna Corrente, Francesco Del Principe, Maria Ilaria Rosati, Serena Falcucci, Paolo Fresa, Alberto Conte, Esmeralda Limongiello, Maria Assunta Renzi, Daniela De Padua, Laura Andriani, Alessandro Pisani, Francesco Cimino, Giuseppe Tafuri, Agostino Montanaro, Marco Mauro, Francesca Romana Del Poeta, Giovanni Laurenti, Luca |
author_facet | Autore, Francesco Innocenti, Idanna Corrente, Francesco Del Principe, Maria Ilaria Rosati, Serena Falcucci, Paolo Fresa, Alberto Conte, Esmeralda Limongiello, Maria Assunta Renzi, Daniela De Padua, Laura Andriani, Alessandro Pisani, Francesco Cimino, Giuseppe Tafuri, Agostino Montanaro, Marco Mauro, Francesca Romana Del Poeta, Giovanni Laurenti, Luca |
author_sort | Autore, Francesco |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-7298101 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-72981012020-06-24 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 Autore, Francesco Innocenti, Idanna Corrente, Francesco Del Principe, Maria Ilaria Rosati, Serena Falcucci, Paolo Fresa, Alberto Conte, Esmeralda Limongiello, Maria Assunta Renzi, Daniela De Padua, Laura Andriani, Alessandro Pisani, Francesco Cimino, Giuseppe Tafuri, Agostino Montanaro, Marco Mauro, Francesca Romana Del Poeta, Giovanni Laurenti, Luca Front Oncol Oncology 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. Frontiers Media S.A. 2020-06-10 /pmc/articles/PMC7298101/ /pubmed/32587827 http://dx.doi.org/10.3389/fonc.2020.00848 Text en Copyright © 2020 Autore, Innocenti, Corrente, Del Principe, Rosati, Falcucci, Fresa, Conte, Limongiello, Renzi, De Padua, Andriani, Pisani, Cimino, Tafuri, Montanaro, Mauro, Del Poeta and Laurenti. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Oncology Autore, Francesco Innocenti, Idanna Corrente, Francesco Del Principe, Maria Ilaria Rosati, Serena Falcucci, Paolo Fresa, Alberto Conte, Esmeralda Limongiello, Maria Assunta Renzi, Daniela De Padua, Laura Andriani, Alessandro Pisani, Francesco Cimino, Giuseppe Tafuri, Agostino Montanaro, Marco Mauro, Francesca Romana Del Poeta, Giovanni Laurenti, Luca 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Oncology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298101/ https://www.ncbi.nlm.nih.gov/pubmed/32587827 http://dx.doi.org/10.3389/fonc.2020.00848 |
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