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Titel:

Poor efficacy and tolerability of R-CHOP in relapsed/refractory chronic lymphocytic leukemia and Richter transformation.

Dokumenttyp:
Journal Article; Journal Article
Autor(en):
Langerbeins, Petra; Busch, Raymonde; Anheier, Nadine; Dürig, Jan; Bergmann, Manuela; Goebeler, Maria-Elisabeth; Hurtz, Hans-Jürgen; Stauch, Martina B; Stilgenbauer, Stephan; Döhner, Hartmut; Fink, Anna-Maria; Cramer, Paula; Fischer, Kirsten; Wendtner, Clemens-Martin; Hallek, Michael; Eichhorst, Barbara
Abstract:
This phase II trial evaluated efficacy and tolerability of R-CHOP for up to 8 courses in Richter transformation (RT) and up to 6 courses in CLL plus autoimmune cytopenia (AIC) or high-risk (HR) features. HR was defined as fludarabine-refractoriness or early relapse (<36 months) after fludarabine-based treatment; 26 patients were included as HR, 19 patients had AIC, and 15 patients had RT. In the HR cohort, overall response rate was 54%, progression-free and overall survival were 9 and 21 months. In AIC patients overall response rate was 74%, progression-free and overall-survival were 10 and 41 months, respectively, and median increase in hemoglobin was 3.4 g/L. RT patients responded in 67%, progression-free was 10 and overall survival 21 months. The most common adverse events were hematologic toxicities in 92%. Severe infections occurred in 28%. Treatment was discontinued early in 45% of all patients mainly as a result of toxicity. This trial shows that R-CHOP has no role in treating complicated CLL. R-CHOP is associated with significant toxicities and fairly low efficacy compared with almost every other CLL-regimen. In RT, it might still be used as an induction therapy before allogeneic stem cell transplantation.
Zeitschriftentitel:
Am J Hematol
Jahr:
2014
Band / Volume:
89
Heft / Issue:
12
Seitenangaben Beitrag:
E239-43
Sprache:
eng
Volltext / DOI:
doi:10.1002/ajh.23841
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/25196783
Print-ISSN:
0361-8609
TUM Einrichtung:
Institut für Medizinische Statistik und Epidemiologie
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