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Flavopiridol treatment of patients aged 70 or older with refractory or relapsed chronic lymphocytic leukemia is a feasible and active therapeutic approach.

Abstract
Older chronic lymphocytic leukemia patients have poor outcomes with standard treatments and are underrepresented in clinical trials. We retrospectively reviewed outcomes of refractory chronic lymphocytic leukemia patients in two age categories (≥70 and <70 years) treated with single-agent flavopiridol, a drug active in genomically high-risk patients, during two trials. No significant difference between older and younger patients was observed in response rates (43 vs. 47%) or progression-free survival (median 8.7 vs. 9.9 months, P>0.80). Although overall survival was worse in older patients (median 2.1 vs. 2.4 years, P=0.02); when adjusted for other factors this difference was no longer significant (P≥0.10). With the exception of infections (older 29% vs. younger 62%) no significant association with toxicity was observed. These data demonstrate that flavopiridol administration to older chronic lymphocytic leukemia patients is feasible, tolerable, and may have similar efficacy to that in younger patients. Development of treatment approaches including flavopiridol should be considered for these older patients.
AuthorsDeborah M Stephens, Amy S Ruppert, Kristie Blum, Jeffrey Jones, Joseph M Flynn, Amy J Johnson, Jia Ji, Mitch A Phelps, Michael R Grever, John C Byrd
JournalHaematologica (Haematologica) Vol. 97 Issue 3 Pg. 423-7 (Mar 2012) ISSN: 1592-8721 [Electronic] Italy
PMID22271900 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Antineoplastic Agents
  • Flavonoids
  • Piperidines
  • alvocidib
Topics
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
  • Flavonoids (administration & dosage, adverse effects, therapeutic use)
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy, mortality)
  • Middle Aged
  • Piperidines (administration & dosage, adverse effects, therapeutic use)
  • Recurrence
  • Survival Analysis
  • Treatment Outcome

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