Idioma:

Systematic review of purine analog treatment for chronic lymphocytic leukemia: lessons for future trials

CLL Trialists’ Collaborative Group (CLLTCG)

Haematologica (Roma), 2012-03, Vol.97 (3), p.428-436 [Periódico revisado por pares]

Pavia: Ferrata Storti Foundation

Texto completo disponível

Citações Citado por

Enviar para

Título:
Systematic review of purine analog treatment for chronic lymphocytic leukemia: lessons for future trials
Autor: CLL Trialists’ Collaborative Group (CLLTCG)
Assuntos: Antineoplastic Agents, Alkylating - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Cancer ; Disease-Free Survival ; Hematologic and hematopoietic diseases ; Humans ; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy ; Leukemia, Lymphocytic, Chronic, B-Cell - mortality ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; Life Sciences ; Medical sciences ; Original and Brief Reports ; Purines - administration & dosage ; Treatment Outcome
É parte de: Haematologica (Roma), 2012-03, Vol.97 (3), p.428-436
Notas: PMCID: PMC3291599
CLLTCG Participating groups and trialists are listed in the “Appendix”.
Descrição: A systematic review of purine analogs revealed heterogeneity between trials in treatment effects on response and progression free survival, but not survival, perhaps partly due to variations in analytical methods. In addition, combination treatments required evaluation. Therefore, individual patient data were sought for all randomized trials in untreated chronic lymphocytic leukemia which involved a purine analog, but which did not include antibody therapies. Sixteen trials were found, addressing seven comparisons. Eight trials, with 2,753 patients, showed that single agent purine analog improved progression free survival (odds ratio=0.71; 95% confidence interval=0.63-0.79). Heterogeneity remained substantial. Three trials, with 1,403 patients, showed that progression free survival was further improved by the addition of cyclophosphamide (odds ratio=0.54; 0.47-0.62). Fewer data were available on the addition of other drugs to purine analog, and none showed clear benefit. Two trials, with 544 patients, suggested cladribine improved progression free survival compared to fludarabine (odds ratio=0.77; 0.63-0.95). No differences were seen in overall survival for any comparisons. In conclusion, purine analogs, particularly combined with cyclophosphamide, significantly improve progression free survival but not survival. Some groups, such as the elderly, may not see the same benefits and maximizing doses may be important for all treatments, including chlorambucil. Longer follow up, consistent definitions and detailed reporting of trials should be encouraged.
Editor: Pavia: Ferrata Storti Foundation
Idioma: Inglês

Links

Voltar para lista de resultados

Anterior Resultado 7 Avançar Ir para próxima página

Realização: Logos de Redes Sociais:

Systematic review of purine analog treatment for chronic lymphocytic leukemia: lessons for future trials

CLL Trialists’ Collaborative Group (CLLTCG)

Pavia: Ferrata Storti Foundation

Buscando em bases de dados remotas. Favor aguardar.