According to an investigation published Online First in The Lancet Oncology, for individuals who have relapsed with the most prevalent type of leukemia, chronic lymphocytic leukemia (CLL), a novel, less toxic, treatment that combines the chemotherapy drug fludarabine and the monoclonal antibody alemtuzumab, considerably increases progression free survival (PFS) and extends the lives of individuals suffering with these disease, in comparison to only fludarabine. The study reveals that this novel medication combination could be a vital treatment for those suffering with this disease.
Lead author Thomas Elter from the University of Cologne, Cologne, Germany, said:
“Unlike common regimens used to treat CLL, the new two-drug combination spares patients from the toxicities of additional alkylating drugs. Moreover, the required dose of each drug is lower when used in combination than when the drugs are used alone, and the dosing schedule of 3 days a month is more convenient for patients than the standard regimen of three times a week for up to 12 weeks.”
As age, and co-occurring illnesses vary significantly among individuals with chronic lymphocytic leukemia, there is not one standard treatment for all patients with the disease, therefore, it is important that several further treatment options need to be available.
The phase 3 trial, randomly assigned patients with CLL across Europe and North America to two groups. One group (168 patients) received fludarabine plus alemtuzumab for a maximum of six 28-day cycles, and the other group (167) patients were assigned to fludarabine alone for the same duration.
They discovered that both progression free survival was considerably greater with the combination treatment (23.7 months) in comparison with fludarabine alone (16.5 months). In addition they found that complete response rates were also significantly improved with the combination of fludarabine plus alemtuzumab. Individuals with advanced disease and older patients also benefited from the combination treatment.
Overall, participants in both groups experienced a similar number and severity of infectious complications. The frequency of grade 3 or 4 neutropenia (low white blood cell count) was similar between both the groups, as was thrombocytopenia (abnormally low number of blood platelets), however, in the combination group anaemia was lower (9%) compared to 17% in the other group, while lymphopenia (abnormally low number of lyphocytes in the blood) was higher in the combination group 94% versus 33% in the fludarabine only group.
Even though the prevalence of serious side effects were higher in the combination group (33%) than the fludarabine only group (25%), the number of individuals who stopped treatment and deaths during treatment were similar in both groups.
Written by Grace Rattue