Gabriela Ghita, MD, and colleagues at the University of Barcelona in Spain report that chemoimmunotherapy prolongs survival of patients with chronic lymphocytic leukemia (CLL).
Out of 1042 consecutive patients diagnosed and followed up from 1980 to December 2010, the researchers selected 484 who had received alkylating agents and no purine analogs or rituximab (n=211), purine analogs but no rituximab (n=159), or purine analogs plus rituximab (n=114) The three groups were balanced for key clinical characteristics such as age, gender, and Binet stage at treatment.
After a median followup of 9.4 years, 148 (44%) patients were still alive. The overall survival of the purine analog plus rituximab group was 65% compared with 43% for the no purine analog/no-rituximab group and 43% for the purine analog group, (p<0.001).
When all patients who did not receive purine analog therapy or rituximab were included in the study (n=211), the statistically significant difference was maintained. Also, patients from both the purine analog group and the purine analog plus rituximab group had poorer prognostic features. The investigators concluded, “These data are in keeping with a conservative therapeutic approach in patients with low risk disease and a poorer risk of patients treated with [purine analog] with or without [rituximab]. This is also an additional argument in favor of the effectiveness of chemoimmunotherapy in high risk patients.”