TY - JOUR
T1 - Cytogenetic prioritization with inclusion of molecular markers predicts outcome in previously untreated patients with chronic lymphocytic leukemia treated with fludarabine or fludarabine plus cyclophosphamide
T2 - A long-term follow-up study of the US intergroup phase III trial E2997
AU - Lucas, David M.
AU - Ruppert, Amy S.
AU - Lozanski, Gerard
AU - Dewald, Gordon W.
AU - Lozanski, Arletta
AU - Claus, Rainer
AU - Plass, Christoph
AU - Flinn, Ian W.
AU - Neuberg, Donna S.
AU - Paietta, Elisabeth M.
AU - Bennett, John M.
AU - Jelinek, Diane F.
AU - Gribben, John G.
AU - Hussein, Mohamad A.
AU - Appelbaum, Frederick R.
AU - Larson, Richard A.
AU - Moore, Dennis F.
AU - Tallman, Martin S.
AU - Byrd, John C.
AU - Grever, Michael R.
N1 - Publisher Copyright:
© 2015 Informa UK, Ltd.
PY - 2015/11/2
Y1 - 2015/11/2
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84947731681&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84947731681&partnerID=8YFLogxK
U2 - 10.3109/10428194.2015.1023800
DO - 10.3109/10428194.2015.1023800
M3 - Article
C2 - 25721902
AN - SCOPUS:84947731681
SN - 1042-8194
VL - 56
SP - 3031
EP - 3037
JO - Leukemia and Lymphoma
JF - Leukemia and Lymphoma
IS - 11
ER -