Bfr (bendamustine, fludarabine, rituximab) Vs. FCR Nonmyeloablative Allogeneic Conditioning In Relapsed/Refractory Chronic Lymphocytic Leukemia (CLL): Outcome Results Including Minimal Residual Disease Analysis.
Khouri I,Saliba R,Challagundla P, et al
Key Points:
101 patients, treated on 3 consecutive trials, between 1999 and 2012.
75 (74%) received FCR and 26 (26%) received BFR.
Tacrolimus and mini-methotrexate for GVHD prophylaxis.
Thymoglobulin used for patients with unrelated donor transplant.
Staged 3 months x first year, 6 months x 5 years, then yearly.
More patients in the BFR group :transplanted unrelated donors.
2-year progression rates in the BFR - 17%, FCR 37%.
2-year PFS rates 75% BFR vs. 40% FCR.
2-year OS rates 92% BFR vs. 68% FCR.
Implications:
Lower rate of progression and improved survival after BFR in alloSCT.
MRD not able to predict risk of progression.
Additional Comments:
- Bendamustine will be superior agent to consider in place of cyclophosphamide in pretransplant regimens consisting of Fludarabine and Rituxmab.
View the original abstract on the ASH website.
