Chlorambucil/Prednisone versus CHOP in Symptomatic Chronic Lymphocytic Leukemias of B-Cell type. A Randomized Trial

Abstract

The therapeutic efficacy of intensive chemotherapy (CHOP) versus palliative low-dose therapy (chlorambucil/prednisone, ChP) was studied in a randomized trial including 258 previously untreated patients with asymptomatic low-grade non-Hodgkin lymphomas stage III and IV. The patients were stratified according to histological subgroup (the Kiel classification). 113 patients with chronic lymphocytic leukemia (CLL), including B-CLL and leukemic lymphoplasmacytoid immunocytoma (1C), were evaluated separately and presented here. The therapeutic goal was to achieve an asymptomatic state in the ChP group, while in patients allocated to CHOP the intention was to reach complete remission. Thus, in the CHOP group a higher response rate was noted than in the ChP group but no statistically significant difference in overall survival was seen. The results do not support the use of intensive chemotherapy as first line therapy in symptomatic CLL.