In a nutshell
This study wanted to assess the outcomes of chemoimmunotherapy in older patients with chronic lymphocytic leukemia (CLL). Researchers found that chemoimmunotherapy is safe and effective in these patients.
Some background
Chronic lymphocytic leukemia is a cancer of the bone marrow. It is often associated with older patients and abnormal genes. It can lead to abnormal cells of the immune system. It is often treated with strong chemotherapy and medication that targets the immune system. Older patients tend to have other medical conditions that may be worsened by strong CLL medication. It is not known what is the best way to treat older patients with CLL.
Methods & findings
3552 patients from several studies were analyzed. 152 were aged 80 or older at the start of treatment. 99% of these patients also had other medical conditions. These included liver, kidney and heart problems. Chemoimmunotherapy with chlorambucil-obinutuzumab (CLB-OB) (Leukeran-Gazyva) was given to 61 (40%) patients. Chemoimmunotherapy with chlorambucil-rituximab (CLB-R) (Leukeran-Rituxan) was given to 56 (37%) patients. The remaining patients received CLB (12.5%), fludarabine (6.5%; Fludara) and 3.9% of patients received other treatments.
Overall, 77% of patients responded to treatments. 13% of patients had no signs of disease after treatment. Survival without signs of cancer lasted for 17.2 months for all patients. Survival without further treatment lasted for 32.2 months. On average, overall survival lasted for 48 months. The average survival without cancer growing or spreading was 28.9 months with CLB-OB and 16.5 months with CLB-R.
Side effects to treatments included low white cell count (35%) and infection (13%). These caused 22% of all deaths. 16.4% of patients died from progressive CLL.
The bottom line
The study concluded that anti-leukemia treatment is safe and effective in older patients with chronic lymphocytic leukemia.
Published By :
British Journal of Haematology
Date :
Nov 21, 2018
