PMID- 28157628
OWN - NLM
STAT- MEDLINE
DCOM- 20170807
LR  - 20180430
IS  - 1873-5835 (Electronic)
IS  - 0145-2126 (Linking)
VI  - 55
DP  - 2017 Apr
TI  - Characterization of treatment and outcomes in a population-based cohort of 
      patients with chronic lymphocytic leukemia referred for cytogenetic testing in 
      British Columbia, Canada.
PG  - 79-90
LID - S0145-2126(17)30023-1 [pii]
LID - 10.1016/j.leukres.2017.01.023 [doi]
AB  - This study evaluates outcomes in chronic lymphocytic leukemia (CLL) based on 
      first-line therapy in a large consecutive population-based cohort of 669 patients 
      with fluorescence in-situ hybridization (FISH) data in British Columbia, Canada 
      during the period when chemoimmunotherapy was standard first-line treatment. When 
      analyzed as a time-dependent variable, patients who required treatment (n=336) 
      had a 4.7 times higher hazard of death than patients who did not (95% confidence 
      interval 2.8-7.9, P<0.001). The majority of patients received 
      fludarabine-rituximab (FR) in front-line. On multivariate Cox regression 
      analysis, fludarabine-based first-line therapy predicted longer 
      time-to-next-treatment (TTNT) (HR 0.53, 95% confidence interval 0.33-0.87, 
      P=0.012) but no difference in overall survival (OS) compared to alkylator-based 
      therapy. Deletion 17p was an independent predictor of worse TTNT and OS. The most 
      common second-line treatments were 
      cyclophosphamide-vincristine-prednisone-rituximab and FR. There was no difference 
      in OS between patients retreated in second-line with the same first-line regimen 
      (n=33) versus different regimen (n=113). In conclusion, front-line treatment with 
      fludarabine leads to a longer time until need for next treatment than 
      alkylator-based therapy; however, fludarabine or alkylator therapy produces no 
      difference in OS. This study provides a historical baseline for the comparison of 
      novel agents with standard treatments in CLL on a population-level.
CI  - Copyright (c) 2017 Elsevier Ltd. All rights reserved.
FAU - Huang, Steven J
AU  - Huang SJ
AD  - Division of Hematology, Leukemia/BMT Program of BC, Vancouver General Hospital, 
      British Columbia Cancer Agency and University of British Columbia, Vancouver, BC, 
      Canada; Cytogenetics Laboratory, Pathology and Laboratory Medicine, Vancouver 
      General Hospital, University of British Columbia, Vancouver, BC, Canada.
FAU - Lee, Lauren J
AU  - Lee LJ
AD  - Division of Hematology, Leukemia/BMT Program of BC, Vancouver General Hospital, 
      British Columbia Cancer Agency and University of British Columbia, Vancouver, BC, 
      Canada.
FAU - Gerrie, Alina S
AU  - Gerrie AS
AD  - Division of Hematology, Leukemia/BMT Program of BC, Vancouver General Hospital, 
      British Columbia Cancer Agency and University of British Columbia, Vancouver, BC, 
      Canada.
FAU - Gillan, Tanya L
AU  - Gillan TL
AD  - Cytogenetics Laboratory, Pathology and Laboratory Medicine, Vancouver General 
      Hospital, University of British Columbia, Vancouver, BC, Canada.
FAU - Bruyere, Helene
AU  - Bruyere H
AD  - Cytogenetics Laboratory, Pathology and Laboratory Medicine, Vancouver General 
      Hospital, University of British Columbia, Vancouver, BC, Canada.
FAU - Hrynchak, Monica
AU  - Hrynchak M
AD  - Molecular Cytogenetic Laboratory, Royal Columbian Hospital, New Westminster, BC, 
      Canada.
FAU - Smith, Adam C
AU  - Smith AC
AD  - Pathology and Laboratory Medicine and Michael Smith Genome Sciences Centre, 
      British Columbia Cancer Agency, Vancouver, BC, Canada.
FAU - Karsan, Aly
AU  - Karsan A
AD  - Pathology and Laboratory Medicine and Michael Smith Genome Sciences Centre, 
      British Columbia Cancer Agency, Vancouver, BC, Canada.
FAU - Ramadan, Khaled M
AU  - Ramadan KM
AD  - Division of Hematology, St. Paul's Hospital and University of British Columbia, 
      Canada.
FAU - Jayasundara, Kavisha S
AU  - Jayasundara KS
AD  - GlaxoSmithKline, Mississauga, Ontario, Canada.
FAU - Toze, Cynthia L
AU  - Toze CL
AD  - Division of Hematology, Leukemia/BMT Program of BC, Vancouver General Hospital, 
      British Columbia Cancer Agency and University of British Columbia, Vancouver, BC, 
      Canada. Electronic address: ctoze@bccancer.bc.ca.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170115
PL  - England
TA  - Leuk Res
JT  - Leukemia research
JID - 7706787
RN  - 4F4X42SYQ6 (Rituximab)
RN  - 5J49Q6B70F (Vincristine)
RN  - 8N3DW7272P (Cyclophosphamide)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - British Columbia
MH  - Cohort Studies
MH  - Cyclophosphamide/therapeutic use
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - In Situ Hybridization, Fluorescence
MH  - Leukemia, Lymphocytic, Chronic, B-Cell/*drug therapy/epidemiology/mortality
MH  - Male
MH  - Middle Aged
MH  - Rituximab/therapeutic use
MH  - Survival Rate
MH  - Vincristine/therapeutic use
OTO - NOTNLM
OT  - Chemoimmunotherapy
OT  - Chronic lymphocytic leukemia
OT  - FISH
OT  - Population-based
OT  - Survival
OT  - Treatment
EDAT- 2017/02/06 06:00
MHDA- 2017/08/08 06:00
CRDT- 2017/02/04 06:00
PHST- 2016/10/31 00:00 [received]
PHST- 2017/01/13 00:00 [accepted]
PHST- 2017/02/06 06:00 [pubmed]
PHST- 2017/08/08 06:00 [medline]
PHST- 2017/02/04 06:00 [entrez]
AID - S0145-2126(17)30023-1 [pii]
AID - 10.1016/j.leukres.2017.01.023 [doi]
PST - ppublish
SO  - Leuk Res. 2017 Apr;55:79-90. doi: 10.1016/j.leukres.2017.01.023. Epub 2017 Jan 
      15.