ONCOmmunity

R-DHAP Immunochemotherapy Is An Effective Remission-Induction Treatment For CLL Patients With Fludarabine Refractory Disease With Or Without Deletion 17p, Enabling The Majority To Proceed To Allogeneic Stem Cell Transplantation

Gelder M, Ghidey W ,Chamuleau M et al.

Key Points:

Allogeneic stem cell transplantation only potentially curative treatment for relapsed CLL patients with fludarabine refractory disease and/or a deletion 17p del(17p).
Bulky disease and lack of response to last treatment predictors for poor survival.
Prospective international multicenter phase 2 study WITH R-DHAP remission-induction.
Received at least 3 cycles of R-DHAP salvage therapy.
40 patients included from February 2009 till April 2012.
The median age 59 years and median number of prior therapies was 2.
Twenty-four patients completed at least 3 cycles of R-DHAP.
ORR for all 39 eligible patients was 56%: 6 CR (15%), 16 PR (41%).
Five patients had SD (13%) and 2 PD (5%).
ORR rates in patients with bulky lymphadenopathy (>5 cm, n=18) and in those having del(17p) (n=17) was 67% and 53% respectively.
Twenty-six patients proceeded to alloSCT (67%). With a median follow-up of 16 months
2-year progression-free survival (PFS) and overall survival (OS) after transplantation are 63% and 72% respectively.

Implications:

R-DHAP an effective remission-induction regimen.

Enabling a high percentage of patients to proceed to alloSCT resulting in high PFS and OS at 2 years.

View the original abstract on the ASH website.