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FC and FCR in CLL and Indolent NHL: A descriptive retrospective institutional study

FC and FCR in CLL and Indolent NHL: A descriptive retrospective institutional study. Aftimos P, Chahine G Hotel-Dieu de France University Hospital Beirut, Lebanon. LSMO 7: National Forum Le Royal, Dbaye 11/14/2008. Indolent NHL: Standard Approaches. Watch and Wait (worry)

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FC and FCR in CLL and Indolent NHL: A descriptive retrospective institutional study

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  1. FC and FCR in CLL and Indolent NHL: A descriptive retrospective institutional study Aftimos P, Chahine G Hotel-Dieu de France University Hospital Beirut, Lebanon LSMO 7: National Forum Le Royal, Dbaye 11/14/2008

  2. Indolent NHL: Standard Approaches • Watch and Wait (worry) • Alkylating agents ± steroids • CVP • CHOP • Fludara • Fludara combination chemo • “New and improved” biological therapies

  3. OBJECTIVE • The purpose of this study is to evaluate the results of treatment of indolent NHL and CLL by FC and FCR.

  4. MATERIAL AND METHODS • Descriptive, retrospective study • Patients with CLL or indolent lymphomas treated by FC or FCR between 1998 and 2004 • Overall survival (OS) and disease-free interval (DFI) have been calculated, and response to treatment registered

  5. RESULTS • 43 patients, 33 treated by FC and 10 by FCR • 26 (60%) ♀ ; 17 (40%) ♂ • Mean age = 62.07 years old • Median age = 61 years old • 53.5% treated first line • 23.3% received Rituximab

  6. Type and Stage

  7. FLIPI index Solal-Celigny et al. Blood 2004

  8. Prognostic Factors • B signs: 79% of patients • Bone marrow infiltration: 70% of patients • Bulky disease: 18.6% of patients • Mean LDH = 775 (Nl: 313-618). 40% elevated • 57% above 60 years old • 79.1% stage III or IV

  9. Survival • Relapse rate = 51.2% • DFI = 20 months • Overall survival: • 85% at 1 year • 68% at 3 years • 55% at 5 years

  10. Hematological Toxicities

  11. Survival Confounding Factors

  12. Best Response (DFI) P = 0.003

  13. Best Response (OS) P = 0.000

  14. Bulky Disease (DFI) P = 0.002

  15. CONCLUSION • Epidemiology, patient and disease characteristics from our series concur with the published data • The first FCR paper published by MD Anderson* showed a RR of 95% (CR = 70%). All patients received Rituximab and were treated upfront. They were younger and had less advanced disease • Update of our series is expected in 2009 with almost 100 patients and uniform administration of Rituximab * J Clin Oncol 2005;23(18):4079-88

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