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Impact of gender on outcome after chemoimmunotherapy in patients with chronic lymphocytic leukemia: a meta-analysis by the German CLL study group

Leukemia volume 31, pages 2251–2253 (2017)Cite this article

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Since the definition of Rai stages in 1975, a more benign course of chronic lymphocytic leukemia (CLL) in female patients as compared to male patients was observed.1 Several chemotherapy trials showed that female patients had a longer progression free survival (PFS) and a longer overall survival than male CLL patients.2, 3, 4 While in lymphoma other than CLL a clinically meaningful difference in PFS of female and male patients has been observed after chemoimmunotherapy (CIT),5, 6 it is not clear whether this effect is maintained with CIT for CLL. Here we report the results of a meta-analysis regarding the prognosis of male and female CLL patients receiving CIT.

A total of 2247 patients were included in this analysis. In total, 1078 fit patients receiving fludarabine, cyclophosphamide and rituximab (FCR) or bendamustine and rituximab (BR) within three phase II/III trials of the German CLL study group (GCLLSG; CLL2M, CLL8, CLL10) were pooled and analyzed. Due to coexisting conditions and therefore different patient characteristics, 657 unfit patients receiving chlorambucil-based (CLB) CIT within the CLL11 trial were evaluated separately. In total, 512 patients receiving chemotherapy without a CD20 antibody (FC or CLB) were analyzed separately as well (Supplementary Figure S1). Patient characteristics are listed in Supplementary Table S1.

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Acknowledgements

We thank the patients and their treating physicians who participated in the trials. This work was presented in part at the Annual Meeting of the German, Austrian and Swiss Society of Hematology and Oncology (Leipzig, Germany, 14–18 October 2016) and the Annual Meeting of the American Society of Hematology (San Diego, USA, 2–6 December 2016). The CLL2M and CLL10 trials were conducted as investigator-initiated trials by the GCLLSG. They were supported by research grants from Roche Pharma AG, Mundipharma, and a grant from the German Federal Ministry of Education. The CLL8 study was conducted as an investigator-initiated trial by the GCLLSG from 2003 to 2004 and afterwards sponsored by F Hoffmann-La Roche.

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Author notes

  1. B Eichhorst and G Hopfinger: These authors contributed equally to this work.

Authors and Affiliations

  1. Department I of Internal Medicine and Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital, Cologne, Germany

    O Al-Sawaf, S Robrecht, J Bahlo, A M Fink, P Cramer, J von Tresckow, C Maurer, K Fischer, V Goede, M Hallek & B Eichhorst

  2. Department of Hematology, Oncology, Immunology, Palliative Care, Infectious Diseases and Tropical Medicine, German CLL Study Group, Hospital Munich-Schwabing, Munich, Germany

    M Bergmann & C M Wendtner

  3. Medical Department III, University Hospital of the Ludwig-Maximilians-University, Munich, Germany

    T Seiler

  4. Department of Hematology and Oncology, Evangelisches Krankenhaus Hamm, Hamm, Germany

    E Lange

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

    M Kneba

  6. Department of Internal Medicine III, German CLL Study Group, University Hospital of Ulm, Ulm, Germany

    S Stilgenbauer & H Döhner

  7. Department of Internal Medicine, Frankfurt (Oder) General Hospital, Frankfurt/Oder, Germany

    M G Kiehl

  8. Division of Hematology and Hemostaeology, Department of Internal Medicine I, Medical University Vienna, Vienna, Austria

    U Jäger

  9. Department of Internal Medicine I, Bone Marrow Transplantation, Medical University of Vienna, Vienna, Austria

    G Hopfinger

Authors
  1. O Al-Sawaf
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  2. S Robrecht
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  3. J Bahlo
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  8. M Bergmann
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  9. T Seiler
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  10. E Lange
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  11. M Kneba
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  15. U Jäger
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  16. C M Wendtner
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  17. K Fischer
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  18. V Goede
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  19. M Hallek
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  20. B Eichhorst
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  21. G Hopfinger
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Corresponding authors

Correspondence to O Al-Sawaf or B Eichhorst.

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Competing interests

OA: Travel grant, honoraria from Roche. SR, JB: Travel grant, honoraria from Roche. AMF: Travel grant, honoraria from Roche, Mundipharma. PC: Travel grant, honoraria and research funding from Roche, Mundipharma. JvT: Travel grant, honoraria, research funding from Roche. CM: Travel grant from Mundipharma. MB: Honoraria from Roche, Mundipharma. MD: Honoria, research funding from Roche, Mundipharma. MK: Honoraria, research funding from Roche. SS: Travel grant, honoraria from Roche. MGK: Travel grants, honoraria from Roche. UJ: Honoraria from Roche. CMW: Grants and personal fees from Hoffmann-La Roche, Mundipharma. KF: Travel grant from Roche. VG: Research funding, honoraria from Roche. MH: Honoraria from Roche, Mundipharma. BE: Honoraria, research funding from Roche, Mundipharma. GH: Honoria, personal fees from Mundipharma, Roche.

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Al-Sawaf, O., Robrecht, S., Bahlo, J. et al. Impact of gender on outcome after chemoimmunotherapy in patients with chronic lymphocytic leukemia: a meta-analysis by the German CLL study group. Leukemia 31, 2251–2253 (2017). https://doi.org/10.1038/leu.2017.221

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