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Efficacy and safety of obinutuzumab-chlorambucil combination in the frontline treatment of elderly patients with chronic lymphocytic leukemia and comorbidities : real‑life data from Polish Adult Leukemia Group (PALG) analysis
chronic lymphocytic leukemia
comorbidities
Cumulative Illness Rating Scale
obinutuzumab
Fludarabine- or bendamustine‑based upfront immunochemotherapy is the current standard of care in fit patients with chronic lymphocytic leukemia (CLL). These regimens are poorly tolerated by patients with comorbidities, for whom the obinutuzumab-chlorambucil combination became the recommended first‑line treatment. We aimed to analyze real‑life experience with the obinutuzumab-chlorambucil combination as the frontline treatment in elderly and unfit patients. The retrospective analysis included 86 elderly patients (median age, 74 years) with CLL and a significant burden of comorbidities, treated with obinutuzumab-chlorambucil as the frontline regimen. All patients had a Cumulative Illness Rating Scale score greater than 6 and/or creatinine clearance of 30 to 69 ml/min. Overall response rate at 2 months after treatment completion was 95.3%, with complete remission (CR) rate of 43% and partial remission (PR) rate of 52.3%. Stable disease rate was 4.7%. Progressive disease was not observed after treatment completion. The median progression‑free survival (PFS) was not reached after a median follow‑up of 18 months; estimated PFS at 30 months was 62%. We observed 6 relapses (7%), 3 (3.5%) in patients obtaining CR, and 3 (3.5%) in those with PR after immunochemotherapy. The most frequent adverse events were neutropenia and infusion‑related reactions (IRRs). Grade-3 neutropenia occurred in 11.6% of patients, and grade-3 IRRs, in 2.3%. There were no adverse events of grade 4 or 5. Our data confirm that the obinutuzumab-chlorambucil combination is an effective and well‑tolerated regimen in untreated CLL patients with comorbidities.
| cris.lastimport.wos | 2024-04-09T18:36:34Z | |
| dc.abstract.en | Fludarabine- or bendamustine‑based upfront immunochemotherapy is the current standard of care in fit patients with chronic lymphocytic leukemia (CLL). These regimens are poorly tolerated by patients with comorbidities, for whom the obinutuzumab-chlorambucil combination became the recommended first‑line treatment. We aimed to analyze real‑life experience with the obinutuzumab-chlorambucil combination as the frontline treatment in elderly and unfit patients. The retrospective analysis included 86 elderly patients (median age, 74 years) with CLL and a significant burden of comorbidities, treated with obinutuzumab-chlorambucil as the frontline regimen. All patients had a Cumulative Illness Rating Scale score greater than 6 and/or creatinine clearance of 30 to 69 ml/min. Overall response rate at 2 months after treatment completion was 95.3%, with complete remission (CR) rate of 43% and partial remission (PR) rate of 52.3%. Stable disease rate was 4.7%. Progressive disease was not observed after treatment completion. The median progression‑free survival (PFS) was not reached after a median follow‑up of 18 months; estimated PFS at 30 months was 62%. We observed 6 relapses (7%), 3 (3.5%) in patients obtaining CR, and 3 (3.5%) in those with PR after immunochemotherapy. The most frequent adverse events were neutropenia and infusion‑related reactions (IRRs). Grade-3 neutropenia occurred in 11.6% of patients, and grade-3 IRRs, in 2.3%. There were no adverse events of grade 4 or 5. Our data confirm that the obinutuzumab-chlorambucil combination is an effective and well‑tolerated regimen in untreated CLL patients with comorbidities. | pl |
| dc.affiliation | Wydział Lekarski : Klinika Hematologii | pl |
| dc.cm.date | 2020-01-07 | |
| dc.cm.id | 90508 | |
| dc.contributor.author | Długosz-Danecka, Monika - 357459 | pl |
| dc.contributor.author | Jurczak, Wojciech - 129923 | pl |
| dc.contributor.author | Łątka-Cabała, Ewa | pl |
| dc.contributor.author | Morawska, Marta | pl |
| dc.contributor.author | Gawroński, Krzysztof | pl |
| dc.contributor.author | Wiśniewska, Anna | pl |
| dc.contributor.author | Dudziński, Marek | pl |
| dc.contributor.author | Wąsik-Szczepanek, Ewa | pl |
| dc.contributor.author | Chmielowska, Ewa | pl |
| dc.contributor.author | Łabędź, Anna | pl |
| dc.contributor.author | Wdowiak, Kamil | pl |
| dc.contributor.author | Hus, Iwona | pl |
| dc.date.accessioned | 2020-01-17T10:00:07Z | |
| dc.date.available | 2020-01-17T10:00:07Z | |
| dc.date.issued | 2018 | pl |
| dc.date.openaccess | 0 | |
| dc.description.accesstime | w momencie opublikowania | |
| dc.description.number | 7-8 | pl |
| dc.description.physical | 421-426 | pl |
| dc.description.points | 30 | pl |
| dc.description.version | ostateczna wersja wydawcy | |
| dc.description.volume | 128 | pl |
| dc.identifier.doi | 10.20452/pamw.4294 | pl |
| dc.identifier.eissn | 1897-9483 | pl |
| dc.identifier.issn | 0032-3772 | pl |
| dc.identifier.project | ROD UJ / OP | pl |
| dc.identifier.uri | https://ruj.uj.edu.pl/xmlui/handle/item/143792 | |
| dc.language | eng | pl |
| dc.language.container | eng | pl |
| dc.rights | Udzielam licencji. Uznanie autorstwa - Użycie niekomercyjne - Na tych samych warunkach 4.0 Międzynarodowa | * |
| dc.rights.licence | CC-BY-NC-SA | |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-sa/4.0/legalcode.pl | * |
| dc.share.type | otwarte czasopismo | |
| dc.source.integrator | false | |
| dc.subject.en | chronic lymphocytic leukemia | pl |
| dc.subject.en | comorbidities | pl |
| dc.subject.en | Cumulative Illness Rating Scale | pl |
| dc.subject.en | obinutuzumab | pl |
| dc.subtype | Article | pl |
| dc.title | Efficacy and safety of obinutuzumab-chlorambucil combination in the frontline treatment of elderly patients with chronic lymphocytic leukemia and comorbidities : real‑life data from Polish Adult Leukemia Group (PALG) analysis | pl |
| dc.title.journal | Polskie Archiwum Medycyny Wewnętrznej = Polish Archives of Internal Medicine | pl |
| dc.type | JournalArticle | pl |
| dspace.entity.type | Publication |
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