Impact of age and comorbidities on the efficacy of FC and FCR regimens in chronic lymphocytic leukemia

被引:9
作者
Strugov, Vladimir [1 ]
Stadnik, Elena [1 ,2 ]
Virts, Yulia [1 ]
Andreeva, Tatyana [1 ]
Zaritskey, Andrey [1 ,2 ]
机构
[1] Almazov Natl Med Res Ctr, Inst Hematol, Akkuratova St 2, St Petersburg 197341, Russia
[2] Pavlov First St Petersburg State Med Univ, Div Hematol, St Petersburg 197022, Russia
关键词
CLL; Chronic lymphocytic leukemia; CIRS-G; Comorbidities; FCR; MYELOID-LEUKEMIA; SURVIVAL; TRIAL; CELL; FLUDARABINE; CHEMOIMMUNOTHERAPY; CYCLOPHOSPHAMIDE; PROGRESSION; EXPRESSION; GUIDELINES;
D O I
10.1007/s00277-018-3409-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
CLL is an aging-associated neoplasm with median age at diagnosis >65years. Little is known about safety and efficacy of FC/FCR regimens in elderly CLL patients with multiple comorbidities. We retrospectively revised medical records of 90 patients treated with FC/FCR regimens in our clinic. Data on demographic and biological characteristics, comorbidities, response to therapy, and treatment-associated adverse events were analyzed. Compared to FC, FCR yielded higher rates of OR (93.6 vs. 81.4%, p=.109) and CR (72.3 vs. 46.5%, p=.018). This translated in longer EFS (median 52 vs. 19months, p=<.001) and OS (median 89 vs. 45months, p=.001). Elderly patients (65 years) had more comorbidities and higher median CIRS-G score (7 vs. 4, p<.001). However, no association was found between CIRS-G score and survival. Decreased renal function was associated with dismal prognosis in patients treated with FCR.
引用
收藏
页码:2153 / 2161
页数:9
相关论文
共 35 条
[1]  
[Anonymous], 2015, CANC FACTS FIG 2015
[2]   Chronic Myeloid Leukemia: An Update of Concepts and Management Recommendations of European LeukemiaNet [J].
Baccarani, Michele ;
Cortes, Jorge ;
Pane, Fabrizio ;
Niederwieser, Dietger ;
Saglio, Giuseppe ;
Apperley, Jane ;
Cervantes, Francisco ;
Deininger, Michael ;
Gratwohl, Alois ;
Guilhot, Francois ;
Hochhaus, Andreas ;
Horowitz, Mary ;
Hughes, Timothy ;
Kantarjian, Hagop ;
Larson, Richard ;
Radich, Jerald ;
Simonsson, Bengt ;
Silver, Richard T. ;
Goldman, John ;
Hehlmann, Rudiger .
JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (35) :6041-6051
[3]  
BINET JL, 1981, CANCER-AM CANCER SOC, V48, P198, DOI 10.1002/1097-0142(19810701)48:1<198::AID-CNCR2820480131>3.0.CO
[4]  
2-V
[5]   Computed tomography scans do not improve the predictive power of 1996 national cancer institute-sponsored working group chronic lymphocytic leukemia response criteria [J].
Blum, Kristie A. ;
Young, Donn ;
Broering, Sarah ;
Lucas, Margaret S. ;
Fischer, Beth ;
Lin, Thomas S. ;
Grever, Michael R. ;
Byrd, John C. .
JOURNAL OF CLINICAL ONCOLOGY, 2007, 25 (35) :5624-5629
[6]   Minimal Residual Disease Quantification Is an Independent Predictor of Progression-Free and Overall Survival in Chronic Lymphocytic Leukemia: A Multivariate Analysis From the Randomized GCLLSG CLL8 Trial [J].
Boettcher, Sebastian ;
Ritgen, Matthias ;
Fischer, Kirsten ;
Stilgenbauer, Stephan ;
Busch, Raymonde M. ;
Fingerle-Rowson, Guenter ;
Fink, Anna Maria ;
Buehler, Andreas ;
Zenz, Thorsten ;
Wenger, Michael Karl ;
Mendila, Myriam ;
Wendtner, Clemens-Martin ;
Eichhorst, Barbara F. ;
Doehner, Hartmut ;
Hallek, Michael J. ;
Kneba, Michael .
JOURNAL OF CLINICAL ONCOLOGY, 2012, 30 (09) :980-988
[7]   Trends in long-term survival of patients with chronic lymphocytic leukemia from the 1980s to the early 21st century [J].
Brenner, Hermann ;
Gondos, Adam ;
Pulte, Dianne .
BLOOD, 2008, 111 (10) :4916-4921
[8]   USE OF FAMILY SPECIFIC LEADER REGION PRIMERS FOR PCR AMPLIFICATION OF THE HUMAN HEAVY-CHAIN VARIABLE REGION GENE REPERTOIRE [J].
CAMPBELL, MJ ;
ZELENETZ, AD ;
LEVY, S ;
LEVY, R .
MOLECULAR IMMUNOLOGY, 1992, 29 (02) :193-203
[9]   National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: Revised guidelines for diagnosis and treatment [J].
Cheson, BD ;
Bennett, JM ;
Grever, M ;
Kay, N ;
Keating, MJ ;
OBrien, S ;
Rai, KR .
BLOOD, 1996, 87 (12) :4990-4997
[10]   Ig V gene mutation status and CD38 expression as novel prognostic indicators in chronic lymphocytic leukemia [J].
Damle, RN ;
Wasil, T ;
Fais, F ;
Ghiotto, F ;
Valetto, A ;
Allen, SL ;
Buchbinder, A ;
Budman, D ;
Dittmar, K ;
Kolitz, J ;
Lichtman, SM ;
Schulman, P ;
Vinciguerra, VP ;
Rai, KR ;
Ferrarini, M ;
Chiorazzi, N .
BLOOD, 1999, 94 (06) :1840-1847