Fludarabine in lymphoproliferative malignancies: a single-centre experience

Area of Science:

• Oncology
• Hematology
• Clinical Pharmacology

Background:

• Fludarabine is an established treatment for chronic lymphocytic leukemia (CLL) and indolent lymphomas.
• Limited data exists on fludarabine's safety and efficacy in Indian patient populations.
• This study retrospectively analyzes fludarabine use in Indian patients with CLL and low-grade lymphomas.

Purpose of the Study:

• To evaluate the safety and efficacy of fludarabine in Indian patients with CLL and low-grade lymphomas.
• To compare treatment outcomes and toxicity profiles with existing international data.
• To assess event-free survival in this specific patient cohort.

Main Methods:

• Retrospective analysis of 47 patients treated with fludarabine between 1999 and 2006.
• Response evaluation using National Cancer Institute-Working Group and International Workshop criteria.
• Toxicity grading per Common Terminology Criteria for Adverse Events v3.0.
• Kaplan-Meier analysis for event-free survival.

Main Results:

• Overall response rates for CLL were 100% upfront and 55% for relapsed disease.
• Low-grade lymphoma response rates were 88% (63% complete remission) upfront and 79% (43% complete remission) for relapsed disease.
• Myelosuppression and infection were common adverse events; higher hematological toxicity observed.
• Median event-free survival was 31.4 months for upfront-treated patients.

Conclusions:

• Fludarabine demonstrates comparable efficacy in Indian patients with CLL and lymphomas to published international data.
• Indian patients experienced a higher frequency of hematological toxicity compared to previous reports.
• Fludarabine remains an effective treatment option, but careful monitoring for toxicity is warranted in this population.