期刊
HAEMATOLOGICA
卷 103, 期 7, 页码 1209-1217出版社
FERRATA STORTI FOUNDATION
DOI: 10.3324/haematol.2018.189837
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资金
- AIL-Ferrara, Italy, Ricerca Finalizzata project Ministero della Salute, Rome, Italy [RF-2011-02349712]
- MIUR, Rome, Italy [PRIN 2015ZMRFEA_004]
- Special Program Molecular Clinical Oncology 5 x 1000 [10007]
- Associazione Italiana per la Ricerca sul Cancro (AIRC), Milan, Italy
- Bloodwise grant [16003]
- United Kingdom's National Institute for Health Research (NIHR)
We performed an observational study on the efficacy of ben-damustine and rituximab (BR) as first salvage regimen in chronic lymphocytic leukemia (CLL). In an intention-to-treat analysis including 237 patients, the median progression-free survival (PFS) was 25 months. The presence of del(17p), unmutated IGHV and advanced stage were associated with a shorter PFS at multivariate analysis. The median time-to-next treatment was 31.3 months. Front-line treatment with a chemoimmunotherapy regimen was the only predictive factor for a shorter time to next treatment at multivariate analysis. The median overall survival (OS) was 74.5 months. Advanced disease stage (i.e. Rai stage III-IV or Binet stage C) and resistant disease were the only parameters significantly associated with a shorter OS. Grade 3-5 infections were recorded in 6.3% of patients. A matched-adjusted indirect comparison with ibrutinib given second-line within Named Patient Programs in the United Kingdom and in Italy was carried out with OS as objective end point. When restricting the analysis to patients with intact 17p who had received chemoimmunotherapy in first line, there was no difference in OS between patients treated with ibrutinib (63% alive at 36 months) and patients treated with BR (74.4% alive at 36 months). BR is an efficacious first salvage regimen in CLL in a real-life population, including the elderly and unfit patients. BR and ibrutinib may be equally effective in terms of OS when used as first salvage treatment in patients without 17p deletion. (Registered at clinicaltrials.gov identifier: 02491398)
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