Clinical observation of fludarabine combined with cyclophosphamide on patients with small lymphotic lymphoma/chronic lymphocytic leukemia

Objective To evaluate the therapeutic effect and adverse reaction of fludarabine and cyclophosphamide for treatment of patients with small lymphotic lymphoma/ chronic lymphocytic leukemia(SLL/CLL).Methods Twenty-one patients with SLL/CLL(eleven patients of whom wrere previously untreated and ten of whom were relapsed/refractory) were treated with FC regiment :fludarabine 25～30 mg·m-2,intravenously guttae,from the first day to the third day,and cyclophosphamide 400～600 mg·m-2,intravenously guttae,the first day,21 days was a treatment cycle and repeated for 6 cycles.Results The average course of twenty-one patients were 4.4.The rate of complete respose(CR),partial response(PR) and overall response(OR) was 61.9%(13/21),28.6%(6/21) and 90.5%(19/21) respectively.There were no significant difference in the rate of CR,PR and OR between previously untreated and relapsed/refractory group(63.6%,36.4%,100% vs 60%,20.0%,80.0% respctively,P0.05).The main adverse reactions included myelosuppression and immunosupression.Grade Ⅲ～Ⅳ leukopenia was found in seven(33.3%) patients,and grade Ⅲ～Ⅳ thrombocytopenia in four(19.1%)patients.Infection and fever occurred in seven(33.3%)patients,but no patient died for that.Other toxicities mainly included nausea vomiting and mild liver,kidney function impairment and autoimmune haemolytic anemia.The median follow-up time was 24 months(rang 1～40 months).2 year survival rate was 90.5%(19/21)and 2 year progression free survival rate was 80.9%(17/21).2 year survival rate and progression free survival rate were 100%(11/11) in the previously untreated group.While in the relapsed/refractory group,2 year survival rate and progression free survival rate were 80.0%(8/10)and 60.0%(6/10) respectively.There was no significant difference between the two groups(P0.05).Conclusion The FC combined chemotherapty regiment on patients with SLL/CLL had a good therapeutic effect and few adverse reaction,but more attention should be given to the long-term effect.