Oberic Lucie, Vaillant Willy, Hebraud Benjamin, Recher Christian, Suc Etienne, Houyau Philippe, Laurent Guy, Ysebaert Loic
Department of Hematology, Purpan University Hospital, Toulouse cedex, France.
Eur J Haematol. 2015 Jan;94(1):37-42. doi: 10.1111/ejh.12391. Epub 2014 Sep 17.
Optimal treatment strategies are lacking in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). Gemcitabine has shown activity and acceptable safety profile in B-cell lymphomas. We present a retrospective case review of gemcitabine and alemtuzumab, every 21 d (for up to six courses) in 27 community-based patients with high-risk R/R CLL. Median age was 70 yr (44-83 yr), 55% patients had Binet stage C, deletion 17p (del(17p)) and/or deletion 11q (del(11q)) were found in 65% and 27%, bulky disease in 55.5%, and fludarabine-refractoriness in 48% of cases, respectively. Overall response rate was 63% (29.6% clinical CR and 33.4% PR). At a median follow-up of 31 months, median PFS and OS were 15.4 and 24 months. In multivariate analysis, median OS is influenced by prior lines of treatment = 3 and bulky disease. Combination of alemtuzumab and gemcitabine appears to be an active, easy to administrate treatment in routine practice, high-risk R/R CLL patients.
复发/难治性（R/R）慢性淋巴细胞白血病（CLL）缺乏最佳治疗策略。吉西他滨在B细胞淋巴瘤中已显示出活性和可接受的安全性。我们对27例社区高危R/R CLL患者每21天（最多六个疗程）使用吉西他滨和阿仑单抗进行回顾性病例分析。中位年龄为70岁（44 - 83岁），55%的患者处于Binet分期C期，65%和27%的患者分别存在17号染色体短臂缺失（del(17p)）和/或11号染色体长臂缺失（del(11q)），55.5%的患者有大包块疾病，48%的病例对氟达拉滨耐药。总缓解率为63%（29.6%为临床完全缓解，33.4%为部分缓解）。中位随访31个月时，中位无进展生存期（PFS）和总生存期（OS）分别为15.4个月和24个月。多因素分析显示，中位总生存期受既往治疗线数≥3和大包块疾病影响。在常规实践中，对于高危R/R CLL患者，阿仑单抗和吉西他滨联合似乎是一种有效的、易于给药的治疗方法。
