title: Fludarabine in patients with advanced and/or resistant B-chronic lymphocytic leukemia.
abstract: In this study, we evaluated the efficacy of fludarabine (FLU), an adenine nucleoside analogue, in 35 previously treated patients with advanced and progressed B-cell chronic lymphocytic leukemia (B-CLL) and in 6 at diagnosis. All patients were treated at a dose of 25 mg/m2 per day for 5 consecutive days (mean number of courses was 5, with a range from 4 to 6). The majority of patients experienced a beneficial effect on hematological parameters. In particular, a remarkable reduction of lymphocyte count together with an increase of neutrophils and platelets was observed. The overall response rate was 42% with 1 complete response and 16 partial responses. Ten patients achieved minor responses and the remaining 14 showed no benefit from treatment. An increased response rate was achieved in 6 untreated patients who showed an overall response rate of 67% (4/6). The major complications observed were neutropenia (66%) and febrile episodes (44%) that were generally infection-related and were fatal in 3 cases. Because we were dealing with patients whose disease was advanced and/or resistant to treatment, the overall results may be considered encouraging with acceptable toxic reactions not superior to those frequently observed with polychemotherapy.
authors.affiliation: Institute of Hematology, University of Bologna, Italy.
authors.forename: P L
authors.initials: PL
authors.lastname: Zinzani
authors.forename: F
authors.initials: F
authors.lastname: Lauria
authors.forename: D
authors.initials: D
authors.lastname: Rondelli
authors.forename: D
authors.initials: D
authors.lastname: Benfenati
authors.forename: D
authors.initials: D
authors.lastname: Raspadori
authors.forename: M
authors.initials: M
authors.lastname: Bocchia
authors.forename: A
authors.initials: A
authors.lastname: Gozzetti
authors.forename: M
authors.initials: M
authors.lastname: Cavo
authors.forename: T M
authors.initials: TM
authors.lastname: Cirio
authors.forename: F
authors.initials: F
authors.lastname: Zaja
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000097:blood / Q000188:drug therapy*; D007958:Leukocyte Count; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology; D010976:Platelet Count; D012074:Remission Induction; D014740:Vidarabine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D014740:Vidarabine; C024352:fludarabine