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Chemoimmunotherapy May Not Be Dead Yet in Chronic Lymphocytic Leukemia, But Fludarabine Plus Cyclophosphamide Plus Rituximab Is Potentially Facing Life Support
Journal of Clinical Oncology ( IF 45.3 ) Pub Date : 2017-12-20 , DOI: 10.1200/jco.2017.75.4721
Stephen Opat 1 , Eliza A. Hawkes 1
Affiliation  

In their recent commentary in Journal of Clinical Oncology, Brown and Kay1 state that “chemoimmunotherapy is not dead yet in chronic lymphocytic leukemia” and extol the virtues of fludarabine plus cyclophosphamide plus rituximab (FCR). We agree with the generally cautious approach to early adoption of novel agents in chronic lymphocytic leukemia (CLL) and the ongoing central role of chemoimmunotherapy. However, although FCR yields good long-term results in a proportion of patients, this cohort is small. We are concerned that there remains a lack of emphasis in the literature on the poor suitability of most patients with CLL for FCR. In our opinion, FCR is associated with unacceptable levels of both early and late toxicity, particularly in older patients, with morbidity evident in clinical practice that is poorly reflected in clinical trials.

中文翻译:

化学免疫疗法可能尚未在慢性淋巴细胞白血病中死亡,但氟达拉滨加环磷酰胺加利妥昔单抗可能会危及生命

在他们最近发表的《临床肿瘤学杂志》上的评论中,Brown和Kay 1指出“化学免疫疗法尚未在慢性淋巴细胞性白血病中死亡”,并赞扬氟达拉滨加环磷酰胺加利妥昔单抗(FCR)的优点。我们同意在慢性淋巴细胞性白血病(CLL)中及早采用新型药物的一般谨慎态度,以及化学免疫疗法的持续核心作用。但是,尽管FCR在部分患者中可产生良好的长期效果,但这一队列很小。我们关注的是,在文献中仍然缺乏对大多数CLL患者FCR适用性差的重视。我们认为,FCR与早期和晚期毒性的不可接受水平相关,尤其是在老年患者中,其在临床实践中的发病率很明显,而在临床试验中却很少反映出来。
更新日期:2017-12-16
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