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Effectiveness of fludarabine in advanced B-cell chronic lymphocytic leukemia.

AbstractAIMS:
The study was carried out to investigate the efficacy and toxicity of fludarabine phosphate in the treatment of B-cell chronic lymphocytic leukemia (B-CLL) in previously treated patients.
METHODS:
Sixteen patients, 11 males and 5 females, 9 in stage B and 7 in stage C, according to the Binet Staging System, were treated with a maximum of 6 cycles of fludarabine (25 mg/m2) for 5 days, every 4 weeks. All patients had been pretreated, 10 were refractory to standard regimens, 5 were in relapse, and 1 patient was in partial remission.
RESULTS:
Thirteen patients were judged suitable for evaluation. Overall 9 patients were responsive to treatment; 4 complete and 5 partial responses were observed. Of the 4 patients in complete remission, 3 were alive at 6, 10 and 13 months, respectively, from the beginning of treatment. One patient died after 11 months for acute graft-versus-host disease after allogenic bone marrow transplantation by an HLA sibling donor. Two of the 5 patients in partial remission were alive at 7 and 17 months, respectively, and the other 3 died (2 of disease reexpansion after 14 and 16 months and 1 of septic shock following pneumonia). Four patients were not responsive to treatment: 1 died from disease progression after 8 months from the beginning of therapy, 1 from cardiac failure after 9 months, 1 from septic shock following meningitis, and 1 was alive after 7 months of follow-up. Treatment was well tolerated, with nausea and vomiting in only one patient. We observed two episodes of pneumonitis, without any evidence of the responsible agent, a tumor lysis syndrome with acute renal failure, a recurrence of autoimmune thrombocytopenia, and a Coombs-positive hemolytic anemia.
CONCLUSIONS:
Fludarabine phosphate is effective in the treatment of patients with advanced B-CLL, even in those refractory to multiple chemotherapy regimens.
AuthorsM Montillo, A Tedeschi, C Delfini, A Olivieri, F D'Adamo, P Leoni
JournalTumori (Tumori) 1995 Nov-Dec Vol. 81 Issue 6 Pg. 419-23 ISSN: 0300-8916 [Print] United States
PMID8804467 (Publication Type: Journal Article)
Chemical References
  • Antineoplastic Agents
  • Vidarabine
  • fludarabine
Topics
  • Aged
  • Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
  • Drug Administration Schedule
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy, pathology)
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Survival Analysis
  • Treatment Outcome
  • Vidarabine (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)

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