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Salvage outcomes in patients with first relapse after fludarabine, cyclophosphamide, and rituximab for chronic lymphocytic leukemia: The F rench intergroup experience
Author(s) -
Fornecker LucMatthieu,
AurranSchleinitz Thérèse,
Michallet AnneSophie,
Cazin Bruno,
Guieze Romain,
Dilhuydy MarieSarah,
Zini JeanMarc,
Tomowiak Cécile,
Lepretre Stéphane,
Cymbalista Florence,
Brion Annie,
Feugier Pierre,
Delmer Alain,
Leblond Véronique,
Ysebaert Loïc
Publication year - 2015
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23999
Subject(s) - fludarabine , alemtuzumab , medicine , rituximab , bendamustine , chemoimmunotherapy , regimen , chronic lymphocytic leukemia , cyclophosphamide , oncology , ofatumumab , progression free survival , salvage therapy , surgery , leukemia , chemotherapy , transplantation , lymphoma
The optimal management of patients with relapsed chronic lymphocytic leukemia (CLL) is dictated by the type of prior therapy, duration of prior response, presence of genomic aberrations, age, and comorbidities. The patterns of relapses and the clinical outcomes of second‐line options after fludarabine‐cyclophosphamide‐rituximab (FCR) is given as a frontline treatment are currently unknown. In this retrospective and non‐randomized study, we report the outcomes of 132 patients from databases of 14 French CLL study group centers who needed a second‐line treatment after FCR frontline. Bendamustine + rituximab (BR) was the most frequently used second‐line regimen, followed by alemtuzumab‐based regimens, R‐CHOP, and FCR. Median progression‐free survival (PFS) was 18 months after BR with a median overall survival (OS) not reached. We also found that response durations of < 36 months and the presence of del(17p) are critical factors that contribute to poor overall survival. BR appears to be an effective salvage regimen in our series, both in terms of progression‐free and overall survival. Patients who relapsed less than 36 months after FCR have a poor outcome, not significantly different in this study from patients with early relapses less than 12 or 24 months. Am. J. Hematol. 90:511–514, 2015. © 2015 Wiley Periodicals, Inc.