Fludarabine monophosphate: a potentially useful agent in chronic lymphocytic leukemia

Recent developments in experimental chemotherapy may benefit patients with chronic lymphocytic leukemia (CLL). Fludarabine monophosphate has shown promise in heavily pretreated patients with advanced CLL. The Southwest Oncology Group has recently completed a phase II investigation of fludarabine in 32 patients. The patient population had a median age of 63 years, median performance status of 1, and included patients with the following stages of the disease: stage 0-3 patients; stage I-5 patients; stage II-6 patients; stage III-4 patients; stage IV-14 patients. A total of 176 courses were administered. Myelosuppression was the most frequent toxicity observed with 13 patients having a decline in platelets, and 11 patients having some decline in granulocytes. Fludarabine monophosphate has had unequivocal antileukemic activity in a group of patients with advanced CLL.