In a nutshell
This study looked at the effectiveness and safety of chemotherapy with bendamustine (Treanda) combined with rituximab (Rituxan) treatment in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). The authors concluded this combination of treatments is an effective and safe treatment for patients with relapsed CLL.
Some background
CLL is a form of leukemia most commonly diagnosed in people over the age of 70. For advanced stages CLL, chemotherapy with fludarabine (Fludara) and cyclophosphamide (Cytoxan) and an antibody treatment such as rituximab have been successful at improving the condition and can even lead to remission (where there are no signs of disease).
Unfortunately some patients will not respond to fludarabine or they may relapse (where the symptoms return). In these cases a different form of treatment is needed. Bendamustine is a different form of chemotherapy that is known to be successful in treating cancers such as CLL. The safety and effectiveness of this drug in combination with rituximab is not yet clear.
Methods & findings
78 patients with CLL were included in this phase II trial. Patients were treated with bendamustine and rituximab every 28 days for up to 6 courses of treatment. The authors measured response to treatment, side effects and event-free survival times (EFS – the length of time after treatment without complications or signs of disease). 22 patients were non-responsive to fludarabine. Patients were followed for an average of 24 months.
There was a response to treatment in 59% of patients. 9% of patients achieved a complete response. 47.4% saw a partial response. Patients responded to the treatment for an average of 15.2 months.
After a two year follow-up, the average EFS time was 14.7 months. Patients with less severe CLL had longer EFS times.
Only 7.1% of patients with deletion 17p (a type of genetic mutation) responded to treatment. Other genetic markers were associated with a better response to treatment.
The most common side effects were infection (12.8%), low red (16.6%) or white blood (23.1%) cell count and low platelet counts (28.2%). 3 patients died as a result of infections during treatment.
The bottom line
The authors concluded that a combination of bendamustine and rituximab is a safe and effective treatment option for patients with relapsed CLL.
The fine print
This study received funding from Hoffman-La Roche, one of the producers of rituximab.
What’s next?
Consult with your physician to discuss your treatment options if you have relapsed for CLL.
Published By :
Journal of clinical oncology
Date :
Sep 10, 2011
