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 Previous Article | Table of Contents | Next Article 
Fludarabine: a new agent with major activity against chronic lymphocytic
leukemia
MJ Keating, H Kantarjian, M Talpaz, J Redman, C Koller, B Barlogie, W Velasquez, W Plunkett, EJ Freireich and KB McCredie
Department of Hematology, University of Texas, M.D. Anderson Cancer Center,
Houston 77030.
Fludarabine was used to treat 68 patients with previously treated chronic
lymphocytic leukemia (CLL). Nine (13%) patients achieved a complete
remission and 30 (44%) a partial remission. The response rates for Rai
stages 0 to 2, 3, and 4 were 64%, 58%, and 50% respectively. Seventeen
(43%) of the 40 Rai stage 1 to 3 patients and four (19%) of the Rai stage 4
patients returned to Rai stage 0. Survival was strongly correlated with the
final Rai stage achieved. The survival of the 11 partial responders with
residual disease consisting only of residual bone-marrow nodules was
similar to the complete responders (36+ months) and superior to the other
partial response patients (16 months). The response to fludarabine was
rapid, with 36 (92%) of the 39 responders having achieved at least a
partial response following the first three courses. Complete responses
occurred in the blood, liver, spleen, and lymph nodes in 48% to 69% of the
patients. Eradication of all disease in the bone marrow occurred in only
13% of the cases. Neutropenia and thrombocytopenia occurred in 56% and 25%
of evaluable courses. Major infections occurred in 9% of evaluable courses
and fevers of unknown origin or minor infections in 12% of courses
respectively. Myelosuppression and infection were more common in patients
with initial Rai stages 3 and 4 and in nonresponding patients. Other
toxicity was mild. No CNS toxicity was noted.
Volume 74,
Issue 1,
pp. 19-25,
07/01/1989
Copyright © 1989 by The American Society of Hematology
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