Unknown

Dataset Information

0

The long-term outcome of patients in the LRF CLL4 trial: the effect of salvage treatment and biological markers in those surviving 10 years.


ABSTRACT: With 10+ years follow-up in the Leukaemia Research Fund (LRF) CLL4 trial, we report the effect of salvage therapy, and the clinical/biological features of the 10-year survivors treated for chronic lymphocytic leukaemia (CLL). Overall survival (OS) was similar in the three randomized arms. With fludarabine-plus-cyclophosphamide (FC), progression-free survival (PFS) was significantly longer (P < 0.0001), but OS after progression significantly shorter, than in the chlorambucil or fludarabine arms (P < 0.0001). 614/777 patients progressed; 524 received second-line and 260 third-line therapy, with significantly better complete remission (CR) rates compared to first-line in the chlorambucil arm (7% vs. 13% after second-, 18% after third-line), but worse in the FC arm (38% vs. 15% after both second and third-line). OS 10 years after progression was better after a second-line CR versus a partial response (36% vs. 16%) and better with FC-based second-line therapy (including rituximab in 20%) or a stem cell transplant (28%) versus all other treatments (10%, P < 0.0001). The 176 (24%) 10-year survivors tended to be aged <70 years, with a "good risk" prognostic profile, stage A-progressive, achieving at least one CR, with a first-line PFS >3 years and receiving ≤2 lines of treatment. In conclusion, clinical/biological features and salvage treatments both influence the long-term outcome. Second-line therapies that induce a CR can improve OS in CLL patients.

SUBMITTER: Else M 

PROVIDER: S-EPMC4832371 | biostudies-other | 2016 Jan

REPOSITORIES: biostudies-other

Similar Datasets

| S-EPMC9896405 | biostudies-literature
| S-EPMC11199238 | biostudies-literature
| S-EPMC10578997 | biostudies-literature
| S-EPMC3472667 | biostudies-literature
| S-EPMC4366593 | biostudies-literature
| S-EPMC5010004 | biostudies-literature
| S-EPMC8608812 | biostudies-literature
| S-EPMC2480486 | biostudies-other
| S-EPMC7415690 | biostudies-literature
| S-EPMC6640174 | biostudies-literature