SALVAGE THERAPY WITH FLUDARABINE IN PATIENTS WITH PROGRESSIVE B-CHRONIC LYMPHOCYTIC-LEUKEMIA

Thirty patients with B-chronic lymphocytic leukemia, aged 45-82 years, were treated with fludarabine. CLL was diagnosed 8-120 months earlier . The patients had been exposed to a median of 3 different regimens be fore treatment with fludarabine, and all had progressive disease when they entered the study. Among the 30 patients, 1 had a metastatic carc inoma and 7 patients with WHO performance status 3 died before the sec ond cycle of fludarabine treatment could be given. The remaining 22 pa tients were considered eligible for response evaluation. The response rate was 32% with 1 complete response and 6 partial responses. However , seven patients achieved stable disease and 8 progressed. The median survival for responders was 24 months and for non-responders 9 months. Response to treatment was correlated with low tumor burden and perfor mance status, In a total of 94 treatment courses, 17 febrile episodes were registered in 10 patients. We conclude that treatment with fludar abine can be useful in patients with progressive and refractory diseas e.