Sustained remissions in CLL after frontline FCR treatment with very-long-term follow-up.
In: Blood, Jg. 142 (2023-11-23), Heft 21, S. 1784
academicJournal
Zugriff:
Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (FCR) achieves durable remissions, with flattening of the progression-free survival (PFS) curve in patients with mutated immunoglobulin heavy chain variable gene (IGHV-M). We updated long-term follow-up results from the original 300-patient FCR study initiated at MD Anderson in 1999. The current median follow-up is 19.0 years. With this extended follow-up, the median PFS for patients with IGHV-M was 14.6 years vs 4.2 years for patients with unmutated IGHV (IGHV-UM). Disease progression beyond 10 years was uncommon. In total, 16 of 94 (17%) patients in remission at 10 years subsequently progressed with the additional follow-up compared with the patients in our prior report in 2015. Only 4 of 45 patients (9%) with IGHV-M progressed beyond 10 years. Excluding Richter transformation, 96 of 300 patients (32%) developed 106 other malignancies, with 19 of 300 (6.3%) developing therapy-related myeloid neoplasms (tMNs), which were fatal in 16 of 19 (84%). No pretreatment patient characteristics predicted the risk of tMNs. In summary, FCR remains an option for patients with IGHV-M chronic lymphocytic leukemia (CLL), with a significant fraction achieving functional cure of CLL. A risk-benefit assessment is warranted when counseling patients, balancing potential functional cure with the risk of late relapses and serious secondary malignancies.
(© 2023 by The American Society of Hematology.)
Titel: |
Sustained remissions in CLL after frontline FCR treatment with very-long-term follow-up.
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Autor/in / Beteiligte Person: | Thompson, PA ; Bazinet, A ; Wierda, WG ; Tam, CS ; O'Brien, SM ; Saha, S ; Peterson, CB ; Plunkett, W ; Keating, MJ |
Zeitschrift: | Blood, Jg. 142 (2023-11-23), Heft 21, S. 1784 |
Veröffentlichung: | 2021- : [New York] : Elsevier ; <i>Original Publication</i>: New York, Grune & Stratton [etc.], 2023 |
Medientyp: | academicJournal |
ISSN: | 1528-0020 (electronic) |
DOI: | 10.1182/blood.2023020158 |
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