In defence of the use of modern chemotherapy regimens for the treatment of patients with chronic lymphocytic leukaemia.

摘要

I read with interest the critique of the United Kingdom LRF CLL4 study published by Haines and his colleagues.1 The LRF CLL4 study was a randomized study of frontline therapy of patients with symptomatic chronic lympho-cytic leukaemia (CLL), comparing treatment with chlorambucil, fludarabine or the combination of fludara-bine and cyclophosphamide (FC). The major results were that FC was the most active regimen in terms of overall response rate (94%), complete remission rate (38%) and progression-free survival (PFS; median 3.6 years). These results were concordant with that of two other randomized comparisons of fludarabine and FC, both of which showed that FC was superior in terms of response rate and PFS. The authors of the LRF CLL4 study concluded that FC should be considered the standard treatment for CLL.