TY - JOUR
TI - Fludarabine monophosphate in refractory B-chronic lymphocytic leukemia:
Maintenance may be significant to sustain response
AU - Angelopoulou, MA
AU - Poziopoulos, C
AU - Boussiotis, VA
AU - Kontopidou, F
AU - and Pangalis, GA
JO - Leukemia & Lymphoma
PY - 1996
VL - 21
TODO - 3-4
SP - 321-324
PB - HARWOOD ACAD PUBL GMBH
SN - 1042-8194, 1029-2403
TODO - 10.3109/10428199209067614
TODO - fludarabine monophosphate; refractory CLL; B-CLL; B-chronic; lymphocytic
leukemia; maintenance therapy
TODO - In the present study we report our results on the efficacy of
Fludarabine monophosphate in 20 B-chronic lymphocytic leukemia (CLL)
patients, refractory to conventional chemotherapy. Of the 20 patients 14
were males and 6 females with a median age of 58 years (44-70). Eight
had Binet stage B and 12 stage C. They were previously treated with
chlorambucil, prednisone, mini-CHOP or irradiation. Their disease
duration prior to fludarabine administration was 49 months (7-180).
Fludarabine was given at a dose of 25mg/m(2) daily, for five consecutive
days, monthly for six months and if responding for six additional
months. Treatment was administered on an outpatient basis. Complete
response (CR) was observed in 7 patients (33%) and partial remission
(PR) in 5 (25%). Of the complete responders 5 were males and 2 females
with a median age of 60 years (range 55-68); three of them had stage B
and 4 stage C disease; the median number of fludarabine courses for
achieving CR was 3 (range 2-5). In all CR patients a residual monoclonal
CD5/CD19 positive lymphocyte population was found in the peripheral
blood. All CRs relapsed shortly after discontinuation of therapy within
12 months. The main toxicity observed was upper respiratory tract and/or
pulmonary infections in 8 patients, requiring hospitalization. Among the
CRs one patient died during the administration of the third course of
therapy, due to a severe hypersensitivity reaction with Stevens-Johnson
syndrome. The importance of maintenance therapy is also stressed as PR
was sustained in some patients using 3 day cycles every 2-4 months. One
patient was maintained in this fashion for 60 + months.
This study showed that fludarabine is effective in CLL patients
refractory to conventional chemotherapy thus it may be given as the
treatment of choice if such patients still require treatment.
ER -