title: Outcomes of first line chemotherapy in patients with chronic lymphocytic leukemia.
abstract: OBJECTIVE
  Chronic lymphocytic leukemia (CLL) is a heterogeneous disease in terms of survival with and without treatment. Many chemo and immunotherapeutic agents are available to treat this indolent disease. Aim of this study was to determine the outcomes of patients with chronic lymphocytic leukemia treated with different available chemotherapeutic regimens.
  
  
  METHODS
  All patients with diagnosis of CLL from 2008 to 2013 were included. Data were collected from hospital information system. Objective response rate (ORR) in terms of complete or partial response (CR, PR), stable or progressive disease (SD, PD), overall survival (OS), and progression free survival (PFS) were calculated.
  
  
  RESULTS
  Fifty seven patients were included; 42 (74%) male and 15 (26%) were female. Patients with Binet stage A 10 (18%); B 20 (35%) and C were 27(47%). Median age was 50.9 years. Forty six (80%) were treated and 11(20%) remained on watch and wait. Treatment indications were B symptoms 14 (30%), symptomatic nodal disease 18(39%), thrombocytopenia 4(9%), anemia 7(15%) and doubling of lymphocyte count 3 (7%). Chemotherapy regimens used were FC in 38 (83%), FCR 5(11%), chlorambucil 2(4%) and CVP in 1(2%) patient. Twenty two (56%) patients had CR, 13(33%) PR, 3(7.6 %) SD, and 1(2.5%) had PD. ORR was 89%. Median PFS was 23.1 months and median 3 years OS was 55%.
  
  
  CONCLUSIONS
  Majority of patients was in a relatively younger age group and presented with advanced stage disease requiring treatment. Small number of patients received rituximab due to cost. PFS and OS are comparable with published literature.
authors.affiliation: Dr. Adil Nazir, MBBS, FCPS Fellow Medical Oncology, Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore - Pakistan.
authors.forename: Adil
authors.initials: A
authors.lastname: Nazir
authors.affiliation: Dr. Fawad MBBS, FCPS Fellow Medical Oncology, Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore - Pakistan.
authors.lastname: Fawad
authors.affiliation: Dr. Sheeraz Ali, MBBS, FCPS Fellow Medical Oncology, Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore - Pakistan.
authors.forename: Sheeraz
authors.initials: S
authors.lastname: Ali
authors.affiliation: Dr. Farhana Badar, Sr. Biostatistician & Cancer Epidemiologist Cancer Registry & Clinical Data Management, Department of Cancer Registry and Clinical Data Management.
authors.forename: Farhana
authors.initials: F
authors.lastname: Badar
authors.affiliation: Dr. Neelam Siddiqui, MBBS, FRCP (Glasgow), CCST (Medical Oncology) UK, Consultant medical oncologist, Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore - Pakistan.
authors.forename: Neelam
authors.initials: N
authors.lastname: Siddique
authors.affiliation: Dr. Abdul Hameed MBBS, MD, FRCP (Edin), Consultant Hematologist, Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore - Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Hameed
keywords: Chemotherapy; Chronic lymphocytic leukemia (CLL)