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High efficacy with five days schedule of oral fludarabine phosphate and cyclophosphamide in patients with previously untreated chronic lymphocytic leukaemia
Author(s) -
Cazin Bruno,
Divine Marine,
Leprêtre Stéphane,
Travade Philippe,
Tournilhac Olivier,
Delmer Alain,
Jaubert Jérôme,
Feugier Pierre,
Dreyfus Brigitte,
Mahé Béatrice,
Grosbois Bernard,
Maloisel Frédéric,
Eghbali Houchingue,
Dumontet Charles,
Bénichou Jacques,
Guibon Odile,
Leleu Xavier,
Leporrier Michel,
Maloum Karim
Publication year - 2008
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2008.07309.x
Subject(s) - fludarabine , medicine , cyclophosphamide , neutropenia , minimal residual disease , chronic lymphocytic leukemia , gastroenterology , toxicity , chemotherapy , surgery , oncology , leukemia
Summary A multicentre single‐arm study testing the efficacy and toxicity of the oral combination of fludarabine and cyclophosphamide (FC) over 5 d in 75 patients with untreated B cell‐chronic lymphocytic leukaemia. Oral FC demonstrated high efficacy with overall (OR) and complete response (CR) rates of 80% and 53%, respectively. Out of the 30 CR patients studied for Minimal Residual Disease (MRD) using 4‐colour flow‐cytometry and the 22 using Clonospecific polymerase chain reaction, 22 (66%) and 16 (68%), respectively, were MRD negative. Median survival and median treatment‐free interval had not been reached at 7 years of follow‐up. Median progression‐free survival (PFS) was 5 years. Toxicity was acceptable, with 52% and 16% of National Cancer Institute grade 3/4 neutropenia and infections, respectively. Gastrointestinal toxicity was mild. Oral FC demonstrated a high efficacy and an acceptable safety profile and may be considered as the standard first line treatment in chronic lymphocytic leukaemia.