| Comparison of chlorambucil and prednisone versus cyclophosphamide, vincristine, and prednisone as initial treatment for chronic lymphocytic leukemia: long-term follow-up of an Eastern Cooperative Oncology Group randomized clinical trial. | |
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MedLine Citation:
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PMID: 2016618 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The Eastern Cooperative Oncology Group (ECOG) conducted a study in which patients with advanced chronic lymphocytic leukemia (CLL) were randomized between a regimen consisting of chlorambucil (30 mg/m2 orally day 1) and prednisone (80 mg orally days 1 to 5) (C + P) administered every 2 weeks and a more intensive regimen of cyclosphosphamide (300 mg/m2 orally days 1 to 5), vincristine (1.4 mg/m2 intravenously [IV] day 1), and prednisone (100 mg/m2 orally days 1 to 5) (CVP) given every 3 weeks. Treatment was continued for up to 18 months to maximal response. Of the 122 eligible patients, 60 received C + P, while 62 received CVP. With a median follow-up of 7 years, there were no significant differences in survival (4.8 v 3.9 years, P = .12), complete remission (CR) rate (25% v 23%; P = .83), or duration of response (2.0 v 1.9 years; P = .78) between C + P and CVP. Toxicity was modest despite the prolonged treatment. The long median survival of 4.1 years for stage III and IV patients is superior to that usually reported. This could stem from continuing treatment to maximal response rather than an increase in intensity of therapy. These results are comparable to those reported with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) therapy by other investigators. The data suggest that intermittent C + P administered to maximal response continues to be the standard treatment approach for advanced CLL. |
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Authors:
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B Raphael; J W Andersen; R Silber; M Oken; D Moore; J Bennett; H Bonner; R Hahn; W H Knospe; J Mazza |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of clinical oncology : official journal of the American Society of Clinical Oncology Volume: 9 ISSN: 0732-183X ISO Abbreviation: J. Clin. Oncol. Publication Date: 1991 May |
Date Detail:
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Created Date: 1991-05-21 Completed Date: 1991-05-21 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8309333 Medline TA: J Clin Oncol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 770-6 Citation Subset: IM |
Affiliation:
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New York University Medical Center, NY 10016. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Antineoplastic Combined Chemotherapy Protocols / therapeutic use* Chlorambucil / administration & dosage Cyclophosphamide / administration & dosage Drug Administration Schedule Female Follow-Up Studies Humans Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*, mortality Male Middle Aged Prednisone / administration & dosage Remission Induction Survival Analysis Vincristine / administration & dosage |
| Grant Support | |
ID/Acronym/Agency:
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CA 16395/CA/NCI NIH HHS; CA 21115/CA/NCI NIH HHS; CA 23318/CA/NCI NIH HHS |
| Chemical | |
Reg. No./Substance:
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305-03-3/Chlorambucil; 50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 57-22-7/Vincristine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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