Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases
<b>Background/Objectives</b><i>:</i> Obinutuzumab was approved for front-line treatment of chronic lymphocytic leukemia in combination with chlorambucil pulses administered every 2 wks. Alternative schedules of chlorambucil enable the administration of higher total chlorambuc...
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2024-12-01
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| author | Igor Aurer Ozren Jakšić Sandra Bašić-Kinda Karla Mišura-Jakobac Jasminka Sinčić-Petričević Sabina Novaković-Coha Davor Galušić Hrvoje Holik Toni Valković Dubravka Županić-Krmek Ida Hude-Dragičević Vibor Milunović Vlatko Pejša |
| author_facet | Igor Aurer Ozren Jakšić Sandra Bašić-Kinda Karla Mišura-Jakobac Jasminka Sinčić-Petričević Sabina Novaković-Coha Davor Galušić Hrvoje Holik Toni Valković Dubravka Županić-Krmek Ida Hude-Dragičević Vibor Milunović Vlatko Pejša |
| author_sort | Igor Aurer |
| collection | DOAJ |
| description | <b>Background/Objectives</b><i>:</i> Obinutuzumab was approved for front-line treatment of chronic lymphocytic leukemia in combination with chlorambucil pulses administered every 2 wks. Alternative schedules of chlorambucil enable the administration of higher total chlorambucil doses, and have better antileukemia activity. So far, evidence on the feasibility of combining obinutuzumab with alternative chlorambucil schedules is lacking. We performed this retrospective analysis to analyze real life outcomes in chronic lymphocytic leukemia patients receiving a combination of obinutuzumab with different chlorambucil schedules. <b>Methods:</b> This was a retrospective survey performed in order to analyze the feasibility and efficacy of different obinutuzumab and chlorambucil combinations in a real-life setting. Patients receiving this combination as a front-line therapy for chronic lymphocytic leukemia in participating centers, outside of clinical trials, in 2017 and 2018 were included. <b>Results:</b> Seventy-three patients fulfilling entry criteria were identified. Their median age was 76 years, and ranged from 58 to 90 years. The median follow up time was 59 months. The response rate was 89%, with a median progression-free survival time of 27 months, and an overall survival time of 49 months. Chlorambucil was administered as planned in 15 of the 22 (79%) patients treated with chlorambucil pulses every 2 weeks; in 15 of the 42 (34%) patients treated with 7-day courses of chlorambucil administered every 4 weeks; and in 0 of the 10 patients treated with a continuous high dose of chlorambucil (<i>p</i> = 0.002). Changes in treatment schedules were made due to side effects. The progression-free and overall survival rates were similar between the three groups. <b>Conclusions:</b> The combinations of obinutuzumab with more intensive chlorambucil schedules are less feasible, preventing the administration of the intended higher total dose of chlorambucil, and do not improve outcomes in comparison to chlorambucil pulses administered every 2 weeks. |
| format | Article |
| id | doaj-art-d8d2366cd134447bb4f0a91302698c4e |
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| language | English |
| publishDate | 2024-12-01 |
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| spelling | doaj-art-d8d2366cd134447bb4f0a91302698c4e2025-08-20T02:00:55ZengMDPI AGBiomedicines2227-90592024-12-011212290210.3390/biomedicines12122902Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic DiseasesIgor Aurer0Ozren Jakšić1Sandra Bašić-Kinda2Karla Mišura-Jakobac3Jasminka Sinčić-Petričević4Sabina Novaković-Coha5Davor Galušić6Hrvoje Holik7Toni Valković8Dubravka Županić-Krmek9Ida Hude-Dragičević10Vibor Milunović11Vlatko Pejša12Division of Hematology, Department of Internal Medicine, University Hospital Centre Zagreb and Medical School, University of Zagreb, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Dubrava and Medical School, University of Zagreb, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Merkur, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Centre Osijek, 31000 Osijek, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Centre Sisters of Mercy, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, Division of Haematology, University Hospital Centre Split, 21000 Split, CroatiaHematology-Oncology Unit, Internal Medicine Service, General Hospital Dr. Josip Benčević, 35000 Slavonski Brod, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Centre Rijeka and Medical School, University of Rijeka, 51000 Rijeka, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Holy Spirit, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Merkur, 10000 Zagreb, CroatiaDivision of Hematology, Department of Internal Medicine, University Hospital Dubrava and Medical School, University of Zagreb, 10000 Zagreb, Croatia<b>Background/Objectives</b><i>:</i> Obinutuzumab was approved for front-line treatment of chronic lymphocytic leukemia in combination with chlorambucil pulses administered every 2 wks. Alternative schedules of chlorambucil enable the administration of higher total chlorambucil doses, and have better antileukemia activity. So far, evidence on the feasibility of combining obinutuzumab with alternative chlorambucil schedules is lacking. We performed this retrospective analysis to analyze real life outcomes in chronic lymphocytic leukemia patients receiving a combination of obinutuzumab with different chlorambucil schedules. <b>Methods:</b> This was a retrospective survey performed in order to analyze the feasibility and efficacy of different obinutuzumab and chlorambucil combinations in a real-life setting. Patients receiving this combination as a front-line therapy for chronic lymphocytic leukemia in participating centers, outside of clinical trials, in 2017 and 2018 were included. <b>Results:</b> Seventy-three patients fulfilling entry criteria were identified. Their median age was 76 years, and ranged from 58 to 90 years. The median follow up time was 59 months. The response rate was 89%, with a median progression-free survival time of 27 months, and an overall survival time of 49 months. Chlorambucil was administered as planned in 15 of the 22 (79%) patients treated with chlorambucil pulses every 2 weeks; in 15 of the 42 (34%) patients treated with 7-day courses of chlorambucil administered every 4 weeks; and in 0 of the 10 patients treated with a continuous high dose of chlorambucil (<i>p</i> = 0.002). Changes in treatment schedules were made due to side effects. The progression-free and overall survival rates were similar between the three groups. <b>Conclusions:</b> The combinations of obinutuzumab with more intensive chlorambucil schedules are less feasible, preventing the administration of the intended higher total dose of chlorambucil, and do not improve outcomes in comparison to chlorambucil pulses administered every 2 weeks.https://www.mdpi.com/2227-9059/12/12/2902chronic lymphocytic leukemiaobinutuzumabchlorambucil |
| spellingShingle | Igor Aurer Ozren Jakšić Sandra Bašić-Kinda Karla Mišura-Jakobac Jasminka Sinčić-Petričević Sabina Novaković-Coha Davor Galušić Hrvoje Holik Toni Valković Dubravka Županić-Krmek Ida Hude-Dragičević Vibor Milunović Vlatko Pejša Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases Biomedicines chronic lymphocytic leukemia obinutuzumab chlorambucil |
| title | Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases |
| title_full | Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases |
| title_fullStr | Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases |
| title_full_unstemmed | Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases |
| title_short | Obinutuzumab in Combination with Alternative Chlorambucil Schedules in Front-Line Treatment of Chronic Lymphocytic Leukemia: A Study by KroHem, the Croatian Cooperative Group for Hematologic Diseases |
| title_sort | obinutuzumab in combination with alternative chlorambucil schedules in front line treatment of chronic lymphocytic leukemia a study by krohem the croatian cooperative group for hematologic diseases |
| topic | chronic lymphocytic leukemia obinutuzumab chlorambucil |
| url | https://www.mdpi.com/2227-9059/12/12/2902 |
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