High dose chlorambucil versus Binet's modified cyclophosphamide, doxorubicin, vincristine, and prednisone regimen in the treatment of patients with advanced B‐cell chronic lymphocytic leukemia

Chronic lymphocytic leukemia

“…Nowadays, based on a type 1 level of evidence and due to the existence of several more efficacious options, chlorambucil is only indicated when palliation of symptoms is the goal of treatment, given daily until a maximal response is reached or All others toxicity appears. Several clinical trials [77][78][79] have reached the following conclusions:…”

“…The rationale for their use stemmed from their effective activity in low-grade lymphomas. Among others, the most used have been CHOP (cyclophosphamide, adriamycin, vincristine and prednisone) [79], CAP (cyclophosphamide, doxorubicin and prednisone) [80] and COP (cyclophosphamide, vincristine and prednisone) [81]. All regimes obtained higher response rates but none showed a benefit in terms of survival a some higher toxicity.…”

An old and simple solution for a new problem ‐ more on clinical staging and evaluation of response in B‐cell chronic lymphocytic leukaemia in the era of new therapies

“…TTM is a simple clinical parameter that takes into account tumour burden in major tumour cell compartments (Fig A). It has been validated in prognostic studies and in several multicentre international clinical trials both for disease progression rate and responsiveness to therapy, and proved to be useful because of its continuous quantitative character based on tumour parameters and not on bone marrow failure parameters (Jaksic et al , ; CLL Trialists Collaborative Group, ; EORTC Leukemia Cooperative Group, ).…”

Treatment options in chronic lymphocytic leukemia

“…Inclusion of an anthracycline in the combination did not affect outcome. In one of these trials involving 228 patients, 48 both the OR rate (90 versus 75%) and median overall survival (68 versus 47 months) were greater with high-dose chlorambucil (15 mg/day until toxicity) than with the low-dose French CHOP regimen.…”