Two-Drug Combo May Help Hard-to-Treat Leukemia
Fludara Plus Campath May Have Advantages Over Standard CLL Treatment
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Side effects in both groups included low white blood cell count and an abnormally low number of blood platelets. The risk of serious complications, including infections, was higher in the combination group. That said, a similar number of people from each group stopped treatment because of side effects. In addition, a similar number of people died in both groups.
Researchers say the combination therapy eliminates the need for certain harsh chemotherapy agents used in other combinations. What’s more, the doses required of Fludara plus Campath are lower when the agents are used together. The new combination may also hold a convenience edge. It is given three days per month. The standard treatment is given three times a week for up to 12 weeks.
"The study shows clear benefits of the combination of Campath and Fludara for relapsed refractory CLL patients," says Hildy Dillon, senior vice president of The Leukemia and Lymphoma Society in White Plains, N.Y.
"Relapsed/refractory or progressive CLL is difficult to control or keep in check, so these results are very encouraging," Dillon says in an email. "It adds another possibility to keep their disease under control and prolong survival."
There is a caveat. "It is not possible to predict in advance which patients will benefit from this combination," she says.
The next step is for people with progressive CLL to ask their oncologists about this combination and whether or not it is an appropriate alternative.
Braunschweig agrees that this combination treatment may have a role in treating CLL. He says that this combination must now be compared to the gold standard, which as of now is a triple combination of Fludara, cyclophosphamide, and Rituxan (rituximab). Cyclophosphamide is a chemotherapy drug. Rituxan is a biologic drug that targets abnormal white blood cells found in people with CLL.
In general, CLL treatment depends on whether or not a person has symptoms, Braunschweig says. Many people who are diagnosed with CLL have no symptoms and are diagnosed based on abnormal blood test results. Others may have general symptoms such as severe fatigue and bleeding.