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Fludarabine and cyclophosphamide in combination with alemtuzumab in patients with primary high-risk, relapsed or refractory chronic lymphocytic leukemia

Leukemia volume 26, pages 2549–2552 (2012)Cite this article

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Chemoimmunotherapies have become a very potent tool to achieve long-lasting remissions in chronic lymphocytic leukemia (CLL) and the addition of rituximab to fludarabine and cyclophosphamide (FCR) was the first treatment shown to increase overall survival.1 Because alemtuzumab as a single agent is more potent than rituximab in CLL, the rationale for this study was to combine this anti-CD52 antibody with a FC chemotherapy backbone.2, 3, 4

A previous trial of fludarabine with alemtuzumab (FluCam) showed excellent results (overall response rate (ORR) 83%, complete response rate (CR) 30%) in relapsed or refractory patients, with a time to progression (TTP) of 35.6 months for all heavily pretreated patients.5 These results have been confirmed in a large randomized phase III trial, comparing FluCam to fludarabine monotherapy in 335 patients with relapsed or refractory disease.6 FluCam demonstrated an excellent treatment outcome and found that both progression-free survival (PFS) (23.7 months vs 16.5 months) and overall survival were significantly better with the combination treatment than with fludarabine alone.5, 6

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Authors and Affiliations

  1. Department I of Internal Medicine and Center of Integrated Oncology (CIO), University of Cologne, Cologne, Germany

    T Elter, R James, P Staib, K Fischer, A-M Fink, J Bahlo, C-M Wendtner, A Engert & M Hallek

  2. Institute of Medical Statistics and Epidemiology, Technical University, Munich, Germany

    R Busch

  3. Department of Internal Medicine III, University of Ulm, Ulm, Germany

    D Winkler, A Bühler, H Döhner & S Stilgenbauer

  4. Second Department of Medicine, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany

    M Ritgen & S Böttcher

  5. Department of Hematology and Oncology, Klinikum Magdeburg, Magdeburg, Germany

    C Kahl

  6. Department of Hematology, St Marien-Krankenhaus, Siegen, Germany

    W Gassmann

  7. Onkologische Schwerpunktpraxis, Kronach, Germany

    M Stauch

  8. Onkologische Schwerpunktpraxis, Siegburg, Germany

    I Hasan

Authors
  1. T Elter
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  2. R James
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  8. W Gassmann
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  11. P Staib
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  12. K Fischer
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  18. S Stilgenbauer
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  19. A Engert
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  20. M Hallek
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written on behalf of the German Chronic Lymphocytic Leukemia Study Group (GCLLSG)

Corresponding author

Correspondence to T Elter.

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Competing interests

The trial was planned and conducted as an investigator-initiated trial by the GCLLSG. It was supported by research grants from Bayer-Schering AG and Genzyme. The GCLLSG receives financial support by the German Cancer Aid. TE, AE, SS, C-MW and MH received honoraria from Bayer-Schering AG and Genzyme. The other authors declare no conflict of interest.

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Elter, T., James, R., Busch, R. et al. Fludarabine and cyclophosphamide in combination with alemtuzumab in patients with primary high-risk, relapsed or refractory chronic lymphocytic leukemia. Leukemia 26, 2549–2552 (2012). https://doi.org/10.1038/leu.2012.129

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