Younger patients with chronic lymphocytic leukemia benefit from rituximab treatment: A single center study in China

Abstract

Chronic lymphocytic leukemia (CLL) is characterized by high heterogeneity in clinical features and outcomes in Western countries and China. In this study, the clinical and laboratory data of 210 CLL patients who were admitted to a single center in China between 2002 and 2011 were retrospectively analyzed. CLL patients had a median age of 60.2 years (range, 35–92 years) and CLL occurred more often in elderly female patients than in male patients (female:male, 1.2:1). The overall response rate [ORR, complete remission (CR) + partial remission (PR)] in the entire cohort of patients was 69.5% and the median overall survival (OS) was 67 months (95% CI, 57.88–76.11). In univariate analysis, an age of >60 years, chromosome 17p deletion (17p−) and elevated β2-MG were associated with a worse OS. Patients with all three poor prognostic factors had a worse outcome than patients with only one or two factors. Patients with 17p− had a significantly lower ORR (P=0.008) and shorter OS (P=0.001) than those without 17p−. Rituximab (R)-based treatment was able to overcome the poor prognosis associated with 17p−. Moreover, the addition of R to fludarabine (F) and cyclophosphamide (C) treatment significantly improved the OS (P=0.012) compared with FC alone in younger patients. However, there were no significant benefits for older patients (P=0.07). This implies that the age of a patient is important in their response to therapy and survival.

Constitutive activation of NF-κB signaling by NOTCH1 mutations in chronic lymphocytic leukemia

“…Results of the present study are in agreement with those of previous reports, which indicated that the clinical factors, biological characteristics, treatment response and prognosis of CLL patients in China vary from those of other countries ( 5 , 6 ). The median survival time of CLL patients was ~67 months, with many individuals developing drug resistance or progressing to aggressive lymphoma, or Richter’s syndrome, during the therapeutic procedure.…”

Long-term Outcomes in Patients with Chronic Lymphocytic Leukemia Treated with Standard Therapy

“…CF efficiency is also comparable to other reports (80%) [34,35]. The best responses, with first-line treatment, were obtained with CFR, a known observation [36] SLP, after the initial treatment, was also better with CFR and matches other studies [36,37] . In one of the pioneer works with CFR and six-year follow-up, SG is 77% [38].…”

Laccase purified from Cerrena unicolor exerts antitumor activity against leukemic cells

“…Certain patients display a favorable course of disease, with stable or slowly increasing lymphocytosis, long survival and no requirement for treatment, whereas other patients experience an aggressive, progressive course of CLL that requires immediate intensive therapy ( 3 , 4 ). The clinical heterogeneity observed in the course of CLL is due to genetic and epigenetic abnormalities ( 2 – 5 ). The microenvironment is additionally known to be involved in leukemogenesis ( 2 – 5 ).…”

“…The clinical heterogeneity observed in the course of CLL is due to genetic and epigenetic abnormalities ( 2 – 5 ). The microenvironment is additionally known to be involved in leukemogenesis ( 2 – 5 ). However, the pathological mechanism of CLL remains to be elucidated ( 2 – 5 ).…”