Treatment approach for elderly and unfit patients with chronic lymphocytic leukemia

Expert Review of Hematology
Idanna InnocentiLuca Laurenti

Abstract

Elderly patients with chronic lymphocytic leukemia (CLL) or patients with comorbidities are often treated with chlorambucil (Chl) as front-line therapy despite relatively low response rates. The addition of a monoclonal anti-CD20 antibody to Chl substantially increases response rates and prolongs progression-free survival (PFS) in these patients, without increasing toxicity. As a result, the ESMO guidelines recommend that previously untreated CLL patients with relevant co-morbidity, but without TP53 deletion/mutation, should be treated with the combination of Chl plus an anti-CD20 antibody (rituximab, ofatumumab or obinutuzumab). Areas covered: This review focuses on the treatment approach of elderly and unfit patients with untreated chronic lymphocytic leukemia. Expert commentary: The addition of a monoclonal anti-CD20 antibody to Chl is currently the suggested treatment in this subset of CLL patients. The choice of the anti-CD20 antibody remains an open question, although obinutuzumab was found to be superior to rituximab, in a head-to-head comparison of Chl-based combinations, in untreated CLL patients with comorbidities, with higher progression free survival, complete remission rates and minimal residual disease-negative re...Continue Reading

References

Jun 21, 2006·The Journal of Immunology : Official Journal of the American Association of Immunologists·Jessica L TeelingJan G J van de Winkel
Feb 7, 2007·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Ian W FlinnMartin S Tallman
Mar 31, 2010·Seminars in Hematology·George J Weiner
Jul 10, 2010·Proceedings of the National Academy of Sciences of the United States of America·Lee A HonigbergJoseph J Buggy
Mar 1, 2012·The Biochemical Journal·Lomon So, David A Fruman
Mar 28, 2012·International Reviews of Immunology·Joseph J Buggy, Laurence Elias
Jan 10, 2014·The New England Journal of Medicine·Valentin GoedeMichael Hallek
Jan 24, 2014·The New England Journal of Medicine·Richard R FurmanSusan M O'Brien
Mar 19, 2014·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Peter HillmenChristopher F E Pocock
Aug 16, 2015·Clinical Cancer Research : an Official Journal of the American Association for Cancer Research·R Angelo de ClaroRichard Pazdur
Sep 1, 2015·Annals of Oncology : Official Journal of the European Society for Medical Oncology·B EichhorstUNKNOWN ESMO Guidelines Committee
Apr 30, 2016·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Massimo GentileFortunato Morabito
Mar 10, 2017·Journal of the National Comprehensive Cancer Network : JNCCN·William G WierdaHema Sundar

❮ Previous
Next ❯

Citations

Aug 30, 2018·Digestive Diseases and Sciences·Thomas A ZikosKirsten A Regalia

❮ Previous
Next ❯

Related Concepts

Related Feeds

B-Cell Leukemia (Keystone)

B-cell leukemia includes various types of lymphoid leukemia that affect B cells. Here is the latest research on B-cell leukemia.