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Older and younger chronic leukemia patients may need different therapy
Date:12/12/2012

d professor of medicine, of medicinal chemistry and of veterinary biosciences at the OSUCCC James.

"The study suggests that chlorambucil is superior to fludarabine in older patients, and that CD20 antibody therapies such as rituximab are beneficial as front-line therapy for all CLL patients, regardless of age," says Byrd, who is the D. Warren Brown Designated Chair in Leukemia Research.

"These data also show that future treatment trials for older adults with CLL should build on CD20 antibody therapies such as rituximab and ofatumumab, but not on fludarabine or alemtuzumab."

Byrd, Woyach and their colleagues reviewed 663 CLL patients who were enrolled in four sequential CLL clinical trials evaluating front-line therapies. The researchers looked for differences in treatment outcomes between older and younger patients to identify the most effective therapy for older adults.

The four trials, all sponsored by the Cancer and Leukemia Group B (CALGB) clinical cooperative group, compared these treatments: chlorambucil versus fludarabine, fludarabine plus rituximab versus fludarabine, fludarabine with consolidation alemtuzumab, and fludarabine plus rituximab with consolidation alemtuzumab.

Key conclusions include:

  • Fludarabine versus chlorambucil: Fludarabine improved progression-free survival and overall survival among patients younger than age 70 but chlorambucil tended to produce higher overall survival in patients older than 70.
  • Rituximab combined with fludarabine, versus fludarabine alone, improves progression-free and overall survival in both younger and older patients.
  • Alemtuzumab consolidation therapy after chemotherapy or chemoimmunotherapy does not improve progression-free or overall survival in either younger or older patients.


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Contact: Darrell E. Ward
Darrell.Ward@osumc.edu
614-293-3737
Ohio State University Medical Center
Source:Eurekalert

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