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Updated: Aug 7, 2026
09:02
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
Purine antagonists for chronic lymphocytic leukaemia
M Steurer1, G Pall, S Richards
1Innsbruck University Hospital, Division of Haematology & Oncology, Anichstrasse 35, A-6020 Innsbruck, Austria. michael.steurer@uibk.ac.at
The Cochrane Database of Systematic Reviews
|July 21, 2006
Summary
Purine antagonists improve response and progression-free survival in B-cell chronic lymphocytic leukemia (B-CLL) but do not significantly improve overall survival. Increased risks of infection and hemolytic anemia are associated with purine antagonist treatment.
Area of Science:
- Oncology
- Hematology
- Clinical Trials
Background:
- Recent trials indicate purine antagonists may offer improved response rates over alkylator-based regimens for B-cell chronic lymphocytic leukemia (B-CLL).
- However, a definitive survival advantage has not been established for purine antagonists in B-CLL treatment.
Purpose of the Study:
- To evaluate the advantage of purine antagonists versus alkylating agents in previously untreated B-CLL patients.
- This systematic review aims to clarify treatment efficacy and safety profiles.
Main Methods:
- Systematic search of medical databases, conference proceedings, and trial registers (1990-2003).
- Inclusion of randomized controlled trials comparing single-agent purine antagonists with alkylator-based regimens.
- Duplicate data extraction and quality assessment, with efforts to obtain missing data from original authors.
Main Results:
- Five trials (1838 patients) showed purine antagonists significantly increased overall response (RR 1.22) and complete remission rates (RR 1.94).
- Progression-free survival was longer with purine antagonists (HR 0.70), though overall survival did not reach statistical significance (HR 0.89).
- Increased risks of grade III/IV infections (RR 1.83) and hemolytic anemia (RR 3.36) were observed with purine antagonists, with no significant difference in neutropenia or treatment-related mortality.
Conclusions:
- Single-agent purine antagonists significantly improve response rates and progression-free survival in first-line B-CLL treatment.
- A statistically significant improvement in overall survival was not detected compared to alkylator-based regimens.
- Purine antagonist use is associated with augmented risks of grade III/IV infections and hemolytic anemia.
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