Fc and fcr in cll and indolent nhl a descriptive retrospective institutional study
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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

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
Indolent NHL: Standard Approaches retrospective institutional study

  • Watch and Wait (worry)

  • Alkylating agents ± steroids

  • CVP

  • CHOP

  • Fludara

  • Fludara combination chemo

  • “New and improved” biological therapies


Objective
OBJECTIVE retrospective institutional study

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


Material and methods
MATERIAL AND METHODS retrospective institutional study

  • 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


Results
RESULTS retrospective institutional study

  • 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


Type and stage
Type and Stage retrospective institutional study


Flipi index
FLIPI index retrospective institutional study

Solal-Celigny et al. Blood 2004


Prognostic factors
Prognostic Factors retrospective institutional study

  • 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


Survival
Survival retrospective institutional study

  • Relapse rate = 51.2%

  • DFI = 20 months

  • Overall survival:

  • 85% at 1 year

  • 68% at 3 years

  • 55% at 5 years


Hematological toxicities
Hematological Toxicities retrospective institutional study


Survival confounding factors

Survival Confounding Factors retrospective institutional study


Best response dfi
Best Response (DFI) retrospective institutional study

P = 0.003


Best response os
Best Response (OS) retrospective institutional study

P = 0.000


Bulky disease dfi
Bulky Disease (DFI) retrospective institutional study

P = 0.002


Conclusion
CONCLUSION retrospective institutional study

  • 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