Cyclophosphamide followed by fludarabine for untreated chronic lymphocytic leukemia: A phase II SWOG TRIAL 9706

M. A. Hussein, H. Gundacker, D. R. Head, L. Elias, K. A. Foon, D. H. Boldt, S. M. Dobin, S. R. Dakhil, G. T. Budd, F. R. Appelbaum

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

B-cell chronic lymphocytic leukemia (CLL) accounts for 95% of chronic leukemia cases and 25% of all leukemia. Despite the prevalence of CLL, progress in its treatment has been only modest over the past three decades. Based upon the ability of fludarabine to produce high-grade remissions especially among patients with low initial tumor mass, and the ability of alkylators to reduce tumor mass, we hypothesized that sequential administration of a limited number of cycles of intermediate-dose cyclophosphamide followed by fludarabine could result in a larger percentage of patients with complete remissions (CRs). In all, 27 of the 49 eligible patients achieved overall responses of CR, unconfirmed complete remission (UCR), or PR, for a total response rate of 55% (95% confidence interval (CI) 40-69%). Considering the confounding medical issues of this patient population with advanced aggressive disease, the regimen was generally well tolerated. This study demonstrates that high-dose cyclophosphamide followed by fludarabine was relatively well tolerated in this group of advanced CLL patients. The study's criterion for testing whether the regimen is sufficiently effective to warrant further investigation was met: 14 (32%) of the first 44 eligible patients achieved CR or UCR.

Original languageEnglish (US)
Pages (from-to)1880-1886
Number of pages7
JournalLeukemia
Volume19
Issue number11
DOIs
StatePublished - Nov 2005

Keywords

  • Chronic lymphocytic leukemia
  • Cyclophosphamide
  • Fludarabine

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Hussein, M. A., Gundacker, H., Head, D. R., Elias, L., Foon, K. A., Boldt, D. H., Dobin, S. M., Dakhil, S. R., Budd, G. T., & Appelbaum, F. R. (2005). Cyclophosphamide followed by fludarabine for untreated chronic lymphocytic leukemia: A phase II SWOG TRIAL 9706. Leukemia, 19(11), 1880-1886. https://doi.org/10.1038/sj.leu.2403940