title: First line Fludarabine treatment of symptomatic chronic lymphoproliferative diseases: clinical results and molecular analysis of minimal residual disease.
abstract: Fludarabine (25 mg/m2 for 5 d, every 4 wk, for 6 courses) was administered as first line therapy in 32 symptomatic chronic lymphoproliferative diseases. All CLL patients achieved at least partial response (5 CR, 2 nPR, 9 PR) but 44% of patients relapsed. In LG-NHLs response and relapse rate were similar. Haematological toxicity was low. VDJ rearrangement PCR analysis was performed on marrow samples at diagnosis and at the time of response evaluation. In the 3 patients who underwent high dose therapy with peripheral blood progenitor cell rescue analysis was also performed on apheresis samples and on marrow samples at the end of the procedure. Clonal VDJ rearrangement was always evident after Fludarabine therapy even in those patients who achieved histological and immunophenotypic complete remission, whereas it disappeared in 2 of 3 patients who underwent HDT. Our data confirm that Fludarabine monotherapy can reduce the neoplastic mass to a subclinical level and suggest the possibility that high dose therapy might produce true complete remission.
authors.affiliation: Department of Internal Medicine, University of Genoa, S. Martino Hospital, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Clavio
authors.forename: M
authors.initials: M
authors.lastname: Miglino
authors.forename: M
authors.initials: M
authors.lastname: Spriano
authors.forename: D
authors.initials: D
authors.lastname: Pietrasanta
authors.forename: E
authors.initials: E
authors.lastname: Vallebella
authors.forename: L
authors.initials: L
authors.lastname: Celesti
authors.forename: L
authors.initials: L
authors.lastname: Canepa
authors.forename: I
authors.initials: I
authors.lastname: Pierri
authors.forename: M
authors.initials: M
authors.lastname: Cavaliere
authors.forename: F
authors.initials: F
authors.lastname: Ballerini
authors.forename: G
authors.initials: G
authors.lastname: Beltrami
authors.forename: E
authors.initials: E
authors.lastname: Rossi
authors.forename: R
authors.initials: R
authors.lastname: Vimercati
authors.forename: R
authors.initials: R
authors.lastname: Bruni
authors.forename: M
authors.initials: M
authors.lastname: Congiu
authors.forename: S
authors.initials: S
authors.lastname: Nati
authors.forename: E
authors.initials: E
authors.lastname: Damasio
authors.forename: G
authors.initials: G
authors.lastname: Santini
authors.forename: M
authors.initials: M
authors.lastname: Gobbi
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008232:Lymphoproliferative Disorders / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine