The experience of the French Cooperative Group in the treatment of CLL.

This paper summarizes results from clinical trials of the French Cooperative Group in chronic lymphocytic leukemia, CLL 80 and CLL 85 protocols. These protocols were based on the (A, B, C) classification. Nine hundred and seventy three patients were randomised in the CLL 80 protocol, 612 in stage A, 289 in stage B and 72 in stage C. Results from the fourth interim analysis were (1) in stage A, overall survival was better in the untreated group as compared to patients treated by daily chlorambucil with an increased incidence of epithelial cancers in the chlorambucil group; (2) in stage B, there was no improvement in overall survival with the COP regimen as compared to daily chlorambucil; (3) in stage C, the effectiveness of the CHOP regimen was confirmed. More than 1,400 patients have been randomised in the CLL 85 protocol but results from the first interim analysis were only available in stage B (194 patients). At the 6-month evaluation 28% reached complete remission in the CHOP group versus 12% in the chlorambucil-prednisone group. More follow-up is needed to assess the benefit from the CHOP regimen in terms of survival in stage B patients.