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.

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 / Rosati, Serena; Falcucci, Paolo; Fresa, Alberto; Conte, Esmeralda; Assunta Limongiello, Maria; Renzi, Daniela; De Padua, Laura; Andriani, Alessandro; Pisani, Francesco; Cimino, Giuseppe; Tafuri, Agostino; Montanaro, Marco; Mauro, Francesca Romana; Del Poeta, Giovanni; Laurenti, Luca. - In: FRONTIERS IN ONCOLOGY. - ISSN 2234-943X. - 10:(2020), pp. 1-7. [10.3389/fonc.2020.00848]

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

Giuseppe Cimino;Agostino Tafuri;Francesca Romana Mauro;
2020

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.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1578479
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