TY - JOUR AU - Laurenti, Luca AU - Vannata, Barbara AU - Innocenti, Idanna AU - Autore, Francesco AU - Santini, Francesco AU - Piccirillo, Nicola AU - Za, Tommaso AU - Bellesi, Silvia AU - Marietti, Sara AU - Sica, Simona AU - Efremov, Dimitar G. AU - Leone, Giuseppe PY - 2013/05/01 Y2 - 2024/03/29 TI - CHLORAMBUCIL PLUS RITUXIMAB AS FRONT-LINE THERAPY IN ELDERLY/UNFIT PATIENTS AFFECTED BY B-CELL CHRONIC LYMPHOCYTIC LEUKEMIA: RESULTS OF A SINGLE-CENTRE EXPERIENCE. JF - Mediterranean Journal of Hematology and Infectious Diseases JA - Mediterr J Hematol Infect Dis VL - 5 IS - 1 SE - Original Articles DO - 10.4084/mjhid.2013.031 UR - https://www.mjhid.org/mjhid/article/view/2013.031 SP - e2013031 AB - <span style="font-family: Times New Roman; font-size: small;"> </span><p class="MsoNormal" style="margin: 0cm 0cm 0pt; text-align: justify; line-height: 150%;"><span style="line-height: 150%; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 14pt; mso-ansi-language: EN-GB; mso-fareast-font-family: TimesNewRomanPSMT;" lang="EN-GB">Currently standard first line therapy for fit patients with B-CLL/SLL are fludarabine-based regimens. </span><span style="line-height: 150%; font-family: &quot;Arial&quot;,&quot;sans-serif&quot;; font-size: 14pt; mso-ansi-language: EN-GB;" lang="EN-GB">Elderly patients or patients with comorbidities poorly tolerate purine analogue-based chemotherapy and they are often treated with Chlorambucil (Chl). <span style="background: white;">However, complete response<span class="apple-converted-space"><sup> </sup></span>(CR) and overall response (OR) rates with Chl are relatively low.</span><span style="color: red;"> </span>We now investigated whether the addition of Rituximab to Chl will improve the efficacy without impairing the tolerability in elderly and unfit patients.<span style="color: red;"> </span><span style="mso-bidi-font-weight: bold;">We included in our study 27 </span>elderly or unfit patients<span style="mso-bidi-font-weight: bold;"> </span>that had not received prior therapy.<span style="color: red;"> </span>All patients were treated with Chl (1mg/Kg per 28-day cycle for 8 cycles) plus Rituximab (375 mg/m<sup>2 </sup><span style="mso-spacerun: yes;"> </span>for the first course and 500 mg/m<sup>2 </sup><span style="mso-spacerun: yes;"> </span>for subsequent cycles until the 6<sup>th</sup> cycle). We obtained an <span style="mso-bidi-font-weight: bold;">OR rate of 74%. The most frequent adverse effect was grade 3-4 neutropenia, which occurred in 18.5% of the patients. Infections or grade 3-4 extra-hematological side effects were not recorded. None of the patients required reduction of dose, delay of therapy or hospitalization. Overall, these data suggest that Chl-R is an effective and well tolerated regimen in elderly/unfit patients with CLL.<span style="mso-spacerun: yes;"> </span><strong></strong></span></span></p><span style="font-family: Times New Roman; font-size: small;"> </span> ER -