First line fludarabine treatment of symptomatic chronic lymphoproliferative diseases: Clinical results and molecular analysis of minimal residual disease

M. Clavio, M. Miglino, M. Spriano, D. Pietrasanta, E. Vallebella, L. Celesti, L. Canepa, I. Pierri, M. Cavaliere, F. Ballerini, G. Beltrami, E. Rossi, R. Vimercati, R. Bruni, M. Congiu, S. Nati, E. Damasio, G. Santini, M. Gobbi

Research output: Contribution to journalArticle

Abstract

Fludarabine (25 mg/m2 for 5 d, every 4 wk, for 6 courses) was administered as first line therapy in 32 symptomatic chronic lymphoproliferative diseases. All CLL patients achieved at least partial response (5 CR, 2 nPR, 9 PR) but 44% of patients relapsed. In LG-NHLs response and relapse rate were similar. Haematological toxicity was low. VDJ rearrangement PCR analysis was performed on marrow samples at diagnosis and at the time of response evaluation. In the 3 patients who underwent high dose therapy with peripheral blood progenitor cell rescue analysis was also performed on apheresis samples and on marrow samples at the end of the procedure. Clonal VDJ rearrangement was always evident after Fludarabine therapy even in those patients who achieved histological and immunophenotypic complete remission, whereas it disappeared in 2 of 3 patients who underwent HDT. Our data confirm that Fludarabine monotherapy can reduce the neoplastic mass to a subclinical level and suggest the possibility that high dose therapy might produce true complete remission.

Original languageEnglish
Pages (from-to)197-203
Number of pages7
JournalEuropean Journal of Haematology
Volume61
Issue number3
Publication statusPublished - 1998

Keywords

  • CLL
  • Fludarabine
  • LG-NHL
  • MRD analysis
  • VDJ rearrangement

ASJC Scopus subject areas

  • Hematology

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  • Cite this

    Clavio, M., Miglino, M., Spriano, M., Pietrasanta, D., Vallebella, E., Celesti, L., Canepa, L., Pierri, I., Cavaliere, M., Ballerini, F., Beltrami, G., Rossi, E., Vimercati, R., Bruni, R., Congiu, M., Nati, S., Damasio, E., Santini, G., & Gobbi, M. (1998). First line fludarabine treatment of symptomatic chronic lymphoproliferative diseases: Clinical results and molecular analysis of minimal residual disease. European Journal of Haematology, 61(3), 197-203.