Long-term survival after fludarabine, cyclophosphamide, and rituximab treatment in previously untreated chronic lymphocytic leukemia patients
Shokhan Mohammad Mustafa1, Ahmed Khudair Yassin1, Nawsherwan S Mohammed2, Rawand P Shamoon2, Marwa N Karam1, Shlan S Mohammad1, Lara Lateef Abdulrahman1, Zhalla O Ahmed3, Bryar Sabah Rashid3, Tavan I Mahmood3, Rozhhat A Yousif4, Kawa M Hasan5, Zeki A Mohamed6, Hisham A Getta7, Sana D Jalal7, Dana A Abdullah7, Basil K Abdulla8, Ghanim S Numan1, Ranan Karadagh3
1 Department of Clinical Hematology, Nanakaly Hospital for Blood Disease, Erbil, Iraq
2 Department of Pathology, College of Medicine, Hawler Medical University, Erbil, Iraq
3 Department of Cnical Hematology, Hiwa Hospital for Blood Disease, Sulaymaniyah, Iraq
4 Azadi Centre for Blood Disease, Duhok, Kurdistan Region, Iraq
5 Department of Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq
6 Department of Medicine, College of Medicine, University of Duhok, Duhok, Kurdistan Region, Iraq
7 Department of Pathology, College of Medicine, University of Sulaymaniyah, Sulaymaniyah, Iraq
8 Department of Hematology, Hiwa Cancer hospital, Sulaymaniyah, Iraq
Dr. Shokhan Mohammad Mustafa
Nanakaly Hospital for Blood Disease, Erbil, Kurdistan Region
Source of Support: None, Conflict of Interest: None
BACKGROUND: Chronic lymphocytic leukemia (CLL) is characterized by a lower incidence rate in Iraq and Kurdistan as compared to Western countries. However, a good prognosis of CLL is dependable on diagnosis, risk stratification, and a better choice of an appropriate treatment regimen.
AIM OF THE STUDY: To evaluate the effectiveness of fludarabine, cyclophosphamide, and rituximab (FCR) regimen in comparison to other chemotherapy regimens in the management of patients with CLL in Kurdistan region/Iraq.
PATIENTS AND METHODS: A retrospective review study carried out in three cancer centers in the Kurdistan region of Iraq for the duration of 10 years through the period from January 1, 2010 to December 31, 2019, on 152 CLL patients. CLL was diagnosed according to the International Workshop on CLL. The treatment of CLL patients was either by FCR chemo-immunotherapy regimen or other chemotherapies.
RESULTS: The FCR chemo-immunotherapy was the treatment of 38.8% of CLL patients, while 61.2% of CLL patients were treated by other chemotherapies. There was a significant association between younger age patients and the use FCR chemo-immunotherapy (P = 0.001). There was a significant association between a complete response and treatment by FCR chemo-immunotherapy (P = 0.02). The mean overall survival duration and progression-free survival of CLL patients treated by FCR chemo-immunotherapy were significantly longer than the mean survival time of CLL patients treated by other chemotherapies (P = 0.01).
CONCLUSIONS: Complete response and survival of CLL patients treated by FCR chemo-immunotherapy were better than the complete response and survival of CLL patients treated by other chemotherapies.