Cytogenetic prioritization with inclusion of molecular markers predicts outcome in previously untreated patients with chronic lymphocytic leukemia treated with fludarabine or fludarabine plus cyclophosphamide: A long-term follow-up study of the US intergroup phase III trial E2997 Journal Article
| Authors: | Lucas, D. M.; Ruppert, A. S.; Lozanski, G.; Dewald, G. W.; Lozanski, A.; Claus, R.; Plass, C.; Flinn, I. W.; Neuberg, D. S.; Paietta, E. M.; Bennett, J. M.; Jelinek, D. F.; Gribben, J. G.; Hussein, M. A.; Appelbaum, F. R.; Larson, R. A.; Moore, D. F.; Tallman, M. S.; Byrd, J. C.; Grever, M. R. |
| Article Title: | Cytogenetic prioritization with inclusion of molecular markers predicts outcome in previously untreated patients with chronic lymphocytic leukemia treated with fludarabine or fludarabine plus cyclophosphamide: A long-term follow-up study of the US intergroup phase III trial E2997 |
| Abstract: | Fludarabine (F) and cyclophosphamide (C) remain backbones of up-front chemotherapy regimens for chronic lymphocytic leukemia (CLL). We report long-term follow-up of a randomized F vs. FC trial in untreated CLL#. With median follow-up of 88 months, estimated median progression-free survival (PFS) was 19.3 vs. 48.1 months for F (n = 109) and FC (n = 118), respectively (p < 0.0001), and median overall survival (OS) was 88.0 vs. 79.1 months (p = 0.96). In multivariable analyses, variables associated with inferior PFS and OS respectively were age (p = 0.002, p < 0.001), Rai stage (p = 0.006, p = 0.02) and sex (p = 0.03, PFS only). Del(17)(p13.1) predicted shorter PFS and OS (p < 0.0001 for each), as did del(11q)(22.3) (p < 0.0001, p = 0.005, respectively), trisomy 12 with mutated Notch1 (p = 0.003, p = 0.03, respectively) and unmutated IGHV (p = 0.009, p = 0.002, respectively), all relative to patients without these features. These data confirm results from shorter follow-up and further justify targeted therapies for CLL. © 2015 Informa UK, Ltd. |
| Journal Title: | Leukemia and Lymphoma |
| Volume: | 56 |
| Issue: | 11 |
| ISSN: | 1042-8194 |
| Publisher: | Taylor & Francis Group |
| Date Published: | 2015-11-01 |
| Start Page: | 3031 |
| End Page: | 3037 |
| Language: | English |
| DOI: | 10.3109/10428194.2015.1023800 |
| PROVIDER: | scopus |
| PUBMED: | 25721902 |
| PMCID: | PMC4688910 |
| DOI/URL: | |
| Notes: | Export Date: 2 December 2015 -- Source: Scopus |
