Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication.

Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. Research Abstract Details 

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Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. Abstract Text:

Francesc Bosch,Ana Ferrer,Neus Villamor,Marcos ,Javier Briones,Eva ,Eugenia Abella,Santiago Gardella,Lourdes Escoda,Elena ,Antoni Asensi, Sayas, Font,Albert ,Ana ,Paola Bertazzoni, Rozman,Marta Aymerich,Eva ,Emili Montserrat,Francesc Bosch,Ana Ferrer,Neus Villamor,Marcos González,Javier Briones,Eva González-Barca,Eugenia Abella,Santiago Gardella,Lourdes Escoda,Elena Pérez-Ceballos,Antoni Asensi,Ma José Sayas,Llorenç Font,Albert Altés,Ana Muntañola,Paola Bertazzoni,María Rozman,Marta Aymerich,Eva Giné,Emili Montserrat,Francesc Bosch,Ana Ferrer,Neus Villamor,Marcos ,Javier Briones,Eva ,Eugenia Abella,Santiago Gardella,Lourdes Escoda,Elena ,Antoni Asensi, Sayas, Font,Albert ,Ana ,Paola Bertazzoni, Rozman,Marta Aymerich,Eva ,Emili Montserrat,

PURPOSE: Fludarabine, cyclophosphamide, and mitoxantrone (FCM) results in a high response rate in previously treated patients with chronic lymphocytic leukemia (CLL). The aim of this study was to investigate FCM as frontline therapy in CLL. EXPERIMENTAL DESIGN: Sixty-nine patients under the age of 65 years with active CLL were treated. Patients received six cycles of fludarabine 25 mg/m(2) i.v. x 3 days, cyclophosphamide 200 mg/m(2) i.v. x 3 days, and mitoxantrone 6 mg/m(2) i.v. x 1 day. Treatment outcome was correlated with clinical and biological variables. The clinical significance of eradicating minimal residual disease (MRD) was also analyzed. RESULTS: The overall response, MRD-negative complete response (CR), MRD-positive CR, nodular partial response (PR), and PR rates were 90%, 26%, 38%, 14%, and 12%, respectively. Severe (grades 3 or 4) neutropenia developed in 10% of the patients. Major and minor infections were reported in 1% and 8% of cases, respectively. Median response duration was 37 months. Patients with del(17p) failed to attain CR. Patients achieving MRD-negative CR had a longer response duration and overall survival than patients with an inferior response. Low serum lactate dehydrogenase levels, low ZAP-70 expression, and mutated IgV(H) genes predicted longer response duration. Finally, both low ZAP-70 and CD38 expression in leukemic cells correlated with MRD-negativity achievement. CONCLUSION: FCM induces a high response rate, including MRD-negative CRs in untreated patients with active CLL. Treatment toxicity is acceptable. Both high ZAP-70 and increased CD38 expression predict failure to obtain MRD-negative response. Patients in whom MRD can be eradicated have longer response duration and overall survival than those with inferior response. These results indicate that FCM can be an ideal companion for chemoimmunotherapy of patients with CLL.

Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. Publishing Authors By Initials

F Bosch,A Ferrer,N Villamor,M ,J Briones,E ,E Abella,S Gardella,L Escoda,E ,A Asensi,MJ Sayas,L Font,A ,A ,P Bertazzoni,M Rozman,M Aymerich,E ,E Montserrat,F Bosch,A Ferrer,N Villamor,M González,J Briones,E González-Barca,E Abella,S Gardella,L Escoda,E Pérez-Ceballos,A Asensi,MJ Sayas,L Font,A Altés,A Muntañola,P Bertazzoni,M Rozman,M Aymerich,E Giné,E Montserrat,F Bosch,A Ferrer,N Villamor,M ,J Briones,E ,E Abella,S Gardella,L Escoda,E ,A Asensi,MJ Sayas,L Font,A ,A ,P Bertazzoni,M Rozman,M Aymerich,E ,E Montserrat,

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Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Clinical cancer research : an official journal of

VOLUME: 14

Page Numbers: 155-61

Journal Abbreviation: Clin. Cancer Res.

ISSN: 1078-0432

DAY: 1

MONTH: Jan

YEAR: 2008

Fludarabine, cyclophosphamide, and mitoxantrone as initial therapy of chronic lymphocytic leukemia: high response rate and disease eradication. Information

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LANGUAGE: eng

NlmUniqueID: 9502500

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AFFILIATION: Authors' Affiliations: Departments of Haematology from Hospital Clínic de Barcelona and Hospital del Mar, Barcelona.

Country: United States

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MEDLINETA: Clin Cancer Res

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