Fludarabine, cyclophosphamide, and rituximab as first‐line treatment in patients with chronic lymphocytic leukemia: A long‐term analysis of the German CLL Study Group (GCLLSG) registry

Author:

Kutsch Nadine1ORCID,Giza Adam1,Robrecht Sandra1,Stumpf Janina1,Federhen Anno1,Stoltefuß Andrea2,Vehling‐Kaiser Ursula3,Koenigsmann Michael4,Tausch Eugen5,Schneider Christof5,Stilgenbauer Stephan5,Illmer Thomas6,Schlag Rudolf7,Dörfel Steffen8,Gaska Tobias9,Kiehl Michael10,Müller‐Hagen Sigrun11,Moorahrend Enno12,Linde Hartmut13,Schlenska‐Lange Anke14,von Tresckow Julia15ORCID,Fischer Kirsten1,Eichhorst Barbara1,Hallek Michael1,Fink Anna Maria1

Affiliation:

1. Department I of Internal Medicine Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, German CLL Study Group, University Hospital Cologne, University of Cologne Cologne Germany

2. Evangelisches Krankenhaus Hamm Hamm Germany

3. ÜBAG MVZ Dr. Vehling‐Kaiser GmbH Landshut Germany

4. Onkologisches Ambulanzzentrum Hannover

5. Division of CLL, Department III of Internal Medicine University Hospital Ulm Ulm Germany

6. Gemeinschaftspraxis Hämatologie‐Onkologie Dresden Germany

7. Hämatologisch‐Onkologische Schwerpunktpraxis Würzburg Würzburg Germany

8. Onkozentrum Dresden Freiberg Dresden Germany

9. Klinik für Hämatologie und Onkologie, Brüderkrankenhaus St. Josef Paderborn Germany

10. Medizinische Klinik I, Klinikum Frankfurt/Oder Frankfurt Germany

11. Praxis für Hämatologie und Onkologie in Hamburg Hamburg Germany

12. Zentrum für Hämatologie und Onkologie MVZ Porta Westfalica Porta Westfalica Germany

13. MVZ für Blut und Krebserkrankungen Potsdam Potsdam Germany

14. Barmherzige Brüder Krankenhaus Regensburg Regensburg Germany

15. Universitätsklinikum Essen Essen Germany

Abstract

AbstractLong‐term data of chronic lymphocytic leukemia (CLL) patients with favorable risk who were treated with fludarabine, cyclophosphamide, and rituximab (FCR) within clinical trials show good efficacy. We here report long‐term data collected within the GCLLSG registry. Altogether, 417 CLL patients who received first‐line treatment with FCR were analyzed, of which 293 (70.3%) were treated outside of clinical trials. The median observation time from first‐line was 95.8 (interquartile range 58.7–126.8) months. Focusing on data of 194 (46.5%) patients who received FCR first‐line treatment after 2013 (start of data collection within GCLLSG registry), responses were documented in 85% of the patients, non‐responses in 15%, and for 3.6% the assessment was missing. Median event‐free survival (EFS, time until disease progression, subsequent treatment, or death) was 60.2 months with a 5‐year EFS‐rate of 50.6%. Patients with higher‐risk disease, characterized by unmutated IGHV (N = 78), had a median EFS of 45.4 months with a 5‐year EFS rate of 36.3%, while the median EFS was 77.5 months with a 5‐year EFS rate of 60.3% in patients with mutated IGHV (N = 40). Median overall survival was not reached with a 5‐year survival rate of 92.7%. In summary, first‐line FCR was associated with long EFS, especially in patients exhibiting a mutated IGHV status.

Publisher

Wiley

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