Liječnički vjesnik, Vol. 139 No. 7-8, 2017.
Original scientific paper
FLUDARABINE, CYCLOPHOSPHAMIDE AND RITUXIMAB (FCR) IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL): UNIVERSITY HOSPITAL CENTRE ZAGREB EXPERIENCE
Ivan Krečak
Sandra Bašić-Kinda
Dino Dujmović
Ida Hude
Ivo Radman-Livaja
Klara Dubravčić
Koraljka Gjadrov Kuveždić
Ivana Ilić
Igor Aurer
Abstract
In clinical trials the combination of fludarabine, cyclophosphamide and rituximab (FCR) demonstrated superior results and became the gold standard for first-line treatment of fit patients with chronic lymphocytic leukemia (CLL). The aim of this study was to evaluate the efficacy, toxicity and feasibility of this protocol in everyday clinical practice. We retrospectively analyzed the outcomes of 43 CLL patients treated at the Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb. The dosing of rituximab differed from that in clinical trials, we administered 375mg/m2 of rituximab per cycle, in previously untreated patients for eight and in relapsed/refractory patients for six cycles. The response rate was 95% with 83% of complete remissions. Twenty–nine patients received FCR as a front–line therapy; three-year overall and progression–free survival were 90% and 80%, respectively. In relapsed/refractory disease three–year overall and progression–free survival were 86% and 62%, respectively. Severe neutropenias occurred in 46% and serious infections in 9% of patients. According to these results, the toxicity profile and treatment outcomes in everyday routine clinical practice are similar to those reported in clinical trials.
Keywords
Leukemia, lymphocytic, chronic, B-cell – complications, drug therapy; Vidarabine – administration and dosage, adverse effects, analogs and derivatives, therapeutic use; Cyclophosphamide – administration and dosage, adverse effects, therapeutic use; Rituximab – administration and dosage, adverse effects, therapeutic use; Antineoplastic agents – administration and dosage, adverse effects, therapeutic use; Antineoplastic combined chemotherapy protocols – administration and dosage, adverse effects, therapeutic use; Treatment outcome; Remission induction; Disease-free survival
Hrčak ID:
189762
URI
Publication date:
23.10.2017.
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