Email this article Evaluation of fludarabine-containing regimens versus immunochemotherapy for chronic lymphOCYtic leukemia
- Authors: Zagoskina T.P.1, Tkachenko S.B.2, Golubeva M.E.3, Kudryavtseva A.V.1, Isaeva N.V.1, Malykh O.V.1, Zagoskina TP4, Tkachenko SB5, Golubeva ME6, Kudryavtseva AV4, Isayeva NV4, Malykh OV4
-
Affiliations:
- ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
- ГОУ НПО "Российская медицинская академия постдипломного образования"
- МУЗ "Клиническая медико-санитарная часть № 1"
- Kirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical Technologies
- Russian Medical Academy of Postgraduate Education
- Town Hematology Center
- Issue: Vol 82, No 1 (2010)
- Pages: 35-39
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/33386
- ID: 33386
Cite item
Full Text
Abstract
Materials and methods. The paper presents the authors' results of treatment in patients with progressive CLL in 2002 to 2007. The study included 229 patients, of them 78 patients received the RFC program, 72 had the FCM program, and 79 had the FC one.
Results. With the use of RFC, a clinically significant therapeutic effect was obtained in 96% of the patients, a complete remission (CR) was in 80% of the primary patients and in 53% of the pretreated patients. When the FCM program was applied, a positive response was noted in 93% of the patients, CR was seen in 75 and 42% of the primary and pretreated patients, respectively. In the treatment of FC, the total effect was 80%, CR was in 41 and 14% of the primary and pretreated patients, respectively.
Conclusion. Comparative analysis of an objective response to therapy has indicated that the effectiveness of the RFC significantly exceeds that of the FCM and FC programs, without enhancing toxicity, which allows he RFC regimen to be regarded as the program of choice in therapy for CLL.
About the authors
Tamara Pavlovna Zagoskina
ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Email: zagoskina@blood.kirov.ru
канд. мед. наук, доц., рук. гематологической клиники; ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Sergey Borisovich Tkachenko
ГОУ НПО "Российская медицинская академия постдипломного образования"
Email: DOC4200@yandex.ru
д-р мед. наук, проф., член-кор. РАМН, зав. каф, клинической физиологии и функциональной диагностики; ГОУ НПО "Российская медицинская академия постдипломного образования"
Marina Evgen'evna Golubeva
МУЗ "Клиническая медико-санитарная часть № 1"
Email: megolubeva@mail.ru
зав. гематологическим центром; МУЗ "Клиническая медико-санитарная часть № 1"
Alevtina Vasil'evna Kudryavtseva
ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Email: zagoskina@blood.kirov.ru
канд. мед. наук, зав. первым гематологическим отд-нием гематологической клиники; ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Natal'ya Vasil'evna Isaeva
ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Email: zagoskina@blood.kirov.ru
канд. мед. наук, ст. науч. сотр., лаб. иммуногематологии; ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Ol'ga Viktorovna Malykh
ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
Email: zagoskina@blood.kirov.ru
мл. науч. сотр., гематологическая клиника; ФГУ "Кировский НИИ гематологии и переливания крови Росмедтехнологий"
T P Zagoskina
Kirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical TechnologiesKirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical Technologies
S B Tkachenko
Russian Medical Academy of Postgraduate EducationRussian Medical Academy of Postgraduate Education
M E Golubeva
Town Hematology CenterTown Hematology Center
A V Kudryavtseva
Kirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical TechnologiesKirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical Technologies
N V Isayeva
Kirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical TechnologiesKirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical Technologies
O V Malykh
Kirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical TechnologiesKirov Research Institute of Hematology and Blood Transfusion, Russian Agency for Medical Technologies
References
- Tothova E., Kafkova A., Fricova M. et al. Fludarabine combined with cyclophosphamide is highly effective in the treatment of chronic lymphocytic leukemia. Neoplasma 2003; 50: 433-437.
- Eichhorst B. F., Busch R., Hopfinger G. et al. Fludarabine plus cyclophosphamide versus fludarabine alone in first line therapy of younger patients with chronic lymphocytic leukemia. Blood 2006; 107: 885-891.
- Abbott B. L. Chronic Lymphocytic Leukemia: Recent Advances in Diagnosis and Treatment. Oncologist 2006; 11 (1): 21- 30.
- Bellosillo В., Villamor N. et al. In vitro evaluation of fludarabine in combination with cyclophosphamide and/or mitoxantrone in B-cell chronic lymphocytic leukemia. Blood 1998; 94: 2836-2843.
- Bosch F., Ferrer A., Lopez-Guillermo A. et al. Fludarabine, cyclophosphamide and mitoxantrone in the treatment of resistant or relapsed chronic lymphocytic leukaemia. Br. J. Haematol. 2002; 119: 976-984.
- Keating M., O'Brien S., Albitar M. et al. Early results of chemoimmunotherapy regimen of fludarabine, cyclophosphamide and rituxmab as initial therapy for chronic lymphocytic leukemia. J. Clin. Oncol. 2005; 23: 4079-4088.
- Wierda W., O'Brien S., Wen S. et al. Chemoimmunotherapy with fludarabine, cyclophosphamide and rituximab for relapsed and refractory chronic lymphocytic leukemia. J. Clin. Oncol. 2005; 23: 4070-4078.
- Byrd J. C., Kitada S., Flinn I. W. et al. The mechanism of tumor cell clearence by rituximab in vivo in patients with B-cell chronic lymphocytic leucaemia evidence of caspase activation and apoptosis induction. Blood 2002; 99: 1038-1043.
- Bannerji R., Kitada S., Flinn I. W. et al. Apoptotic regulatory and complement-protecting protein expression in chronic lymphocytic leukemia: relatonship to in vivo rituximab resistance. J. Clin. Oncol. 2003; 21: 1466-1471.
- Di Gaetano N., Gitteria E., Nota R. et al. Complement activation determines the therapeutic activity of rituximab in vivo. J. Immunol. 2003; 171: 1581-1587.
- Cheson B. D., Bennett J. M., Grever M. et al. National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment. Blood 1996; 87: 4990-4997.
- Bosh F., Montserrat E. Refining prognostic factors in chronic lymphocytic leukemia. Rev. Clin. Exp. Hematol. 2002; 6 (4): 335-349, 449-450.
- Montillo M., Hamblin Т., Hallek M. et al. Chronic lymphocytic leukemia: novel prognostic factors and their relevance for risk-adapted therapeutic strategies. Haematologica 2005; 90 (3): 391-399.
- Montserrat E. New prognostic markers in CLL. Hematology 2006; 279-284.
- Wierda W. G., O'Brien S., Wang X. et al. Prognostic nomogram and index for overall survival in previously untreated patients with chronic lymphocytic leukemia. Blood 2007; 109 (11): 4679-4685.
- Sayala H. A., Rawstron A. S., Hillmen P. Minimal residual disease assessment in chronic lymphocytic leukaemia. Best Pract. Res. Clin. Haematol. 2007; 20: 499-512.
