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Blood, 15 August 2008, Vol. 112, No. 4, pp. 975-980. Prepublished online as a Blood First Edition Paper on April 14, 2008; DOI 10.1182/blood-2008-02-140582. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2008-02-140582v1 112/4/975    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Tam, C. S. Articles by Keating, M. J. Search for Related Content PubMed PubMed Citation Articles by Tam, C. S. Articles by Keating, M. J. Related Collections Neoplasia Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Long-term results of the fludarabine, cyclophosphamide, and rituximab regimen as initial therapy of chronic lymphocytic leukemia Constantine S. Tam1, Susan O'Brien1, William Wierda1, Hagop Kantarjian1, Sijin Wen2, Kim-Anh Do2, Deborah A. Thomas1, Jorge Cortes1, Susan Lerner1, and Michael J. Keating1 Departments of1 Leukemia and 2 Biostatistics, University of Texas M. D. Anderson Cancer Center, Houston Early results of the fludarabine, cyclophosphamide, and rituximab (FCR) regimen in 224 patients showed that it was highly active as initial therapy of chronic lymphocytic leukemia. In this report, we present the final results of all 300 study patients at a median follow up of 6 years. The overall response rate was 95%, with complete remission in 72%, nodular partial remission in 10%, partial remission due to cytopenia in 7%, and partial remission due to residual disease in 6%. Two patients (< 1%) died within 3 months of starting therapy. Six-year overall and failure-free survival were 77% and 51%, respectively. Median time to progression was 80 months. Pretreatment characteristics independently associated with inferior response were age 70 years or older, β2-microglobulin twice the upper limit of normal (2N) or more, white cell count 150 x 109/L or more, abnormal chromosome 17, and lactate dehydrogenase 2N or more. No pretreatment characteristic was independently associated with decreased complete remission duration. The risk of late infection was 10% and 4% for the first and second years of remission, respectively, and less than 1.5% per year for the third year onward. In a multivariate analysis of patients receiving fludarabine-based therapy at our center, FCR therapy emerged as the strongest independent determinant of survival. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Further progress in CLL therapy Emili Montserrat Blood 2008 112: 924-925. [Full Text] [PDF] This article has been cited by other articles: A. V. Kurtova, K. Balakrishnan, R. Chen, W. Ding, S. Schnabl, M. P. Quiroga, M. Sivina, W. G. Wierda, Z. Estrov, M. J. Keating, et al. Diverse marrow stromal cells protect CLL cells from spontaneous and drug-induced apoptosis: development of a reliable and reproducible system to assess stromal cell adhesion-mediated drug resistance Blood, November 12, 2009; 114(20): 4441 - 4450. [Abstract] [Full Text] [PDF] J. Delgado, D. W. Milligan, and P. Dreger Allogeneic hematopoietic cell transplantation for chronic lymphocytic leukemia: ready for prime time? 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Relevance of the immunoglobulin VH somatic mutation status in patients with chronic lymphocytic leukemia treated with fludarabine, cyclophosphamide, and rituximab (FCR) or related chemoimmunotherapy regimens Blood, April 2, 2009; 113(14): 3168 - 3171. [Abstract] [Full Text] [PDF] W. G. Wierda, S. O'Brien, X. Wang, S. Faderl, A. Ferrajoli, K.-A. Do, G. Garcia-Manero, J. Cortes, D. Thomas, C. Koller, et al. Characteristics Associated With Important Clinical End Points in Patients With Chronic Lymphocytic Leukemia at Initial Treatment J. Clin. Oncol., April 1, 2009; 27(10): 1637 - 1643. [Abstract] [Full Text] [PDF] T. Ahmadi and S. J. Schuster Variations on the Fludarabine, Cyclophosphamide, and Rituximab Combination in Chronic Lymphocytic Leukemia Therapy: What Have We Learned? J. Clin. Oncol., February 1, 2009; 27(4): 479 - 480. [Full Text] [PDF] J. G. Gribben Molecular Profiling in CLL Hematology, January 1, 2008; 2008(1): 444 - 449. [Abstract] [Full Text] [PDF]

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