Universität zu Köln

Al-Sawaf, Othman, Bazeos, Alexandra, Robrecht, Sandra, Bahlo, Jasmin, Gower, Craig, Fink, Anna-Maria, Tresckow, Julia, Cramer, Paula, Langerbeins, Petra, Kutsch, Nadine, Humphrey, Kathryn, Fingerle-Rowson, Guenter, Stilgenbauer, Stephan, Wendtner, Clemens-Martin, Fischer, Kirsten, Eichhorst, Barbara, Hallek, Michael and Goede, Valentin (2019). Mode of progression after first line treatment correlates with outcome of chronic lymphocytic leukemia (CLL). Am. J. Hematol., 94 (9). S. 1002 - 1007. HOBOKEN: WILEY. ISSN 1096-8652

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Abstract

In CLL, progressive disease (PD) following remission after first line treatment can present with varying phenotypes. We hypothesized that the mode of PD correlates with clinical outcomes. Data from three phase III trials of the German CLL Study Group (GCLLSG) (CLL8, CLL10, CLL11) including a total of 2159 patients receiving first line (immuno)-chemotherapy (FCR, FC, CLB, CLB-R, CLB-Ob) were analyzed. Patients were categorized as ALC if PD was due to increasing absolute lymphocyte count, or as Ly if due to lymphadenopathy. A group of 241 patients progressed with ALC, and 727 progressed with Ly, including 329 who progressed on both modalities. In fit patients, median TTNT after PD in the Ly group was 12.3 months vs 17.0 months in the ALC group (HR 1.299 [1.036-1.628]; P = .024). Median OS after PD was 45.1 months in the Ly group and 42.4 months in the ALC group (HR=1.023 [0.753-1.389]; P = .885). For unfit patients, median TTNT in the Ly group was 11.7 months vs 21.4 months in the ALC group (HR 1.357 [1.051-1.753]; P = .019). Median OS was 42.8 months in the Ly group and not reached in the ALC group (HR 1.851 [1.280-2.677]; P = .001). Patients in the Ly group more frequently showed impairment of quality of life (QoL). This analysis demonstrates that patients with progressive lymphadenopathy have a significantly shorter TTNT, OS and less favorable QoL. Our findings might help physicians to better estimate the clinical course of a progressing CLL patient.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Al-Sawaf, Othman UNSPECIFIED UNSPECIFIED UNSPECIFIED Bazeos, Alexandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Robrecht, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahlo, Jasmin UNSPECIFIED UNSPECIFIED UNSPECIFIED Gower, Craig UNSPECIFIED UNSPECIFIED UNSPECIFIED Fink, Anna-Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Tresckow, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Cramer, Paula UNSPECIFIED UNSPECIFIED UNSPECIFIED Langerbeins, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Kutsch, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED Humphrey, Kathryn UNSPECIFIED UNSPECIFIED UNSPECIFIED Fingerle-Rowson, Guenter UNSPECIFIED UNSPECIFIED UNSPECIFIED Stilgenbauer, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Wendtner, Clemens-Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Kirsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Eichhorst, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Goede, Valentin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-135373
DOI:	10.1002/ajh.25561
Journal or Publication Title:	Am. J. Hematol.
Volume:	94
Number:	9
Page Range:	S. 1002 - 1007
Date:	2019
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1096-8652
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OPEN-LABEL; CYCLOPHOSPHAMIDE; FLUDARABINE; RITUXIMAB; DIAGNOSIS; PHASE-3 Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13537