Sustained remissions in CLL after frontline FCR treatment with very long-term follow-up

A long-term study, with a median follow-up of 19 years, has shown that patients with mutated IGHV who received fludarabine, cyclophosphamide, and rituximab (FCR) for CLL are more likely to die from other causes than CLL. The PFS for these patients was 14.6 years vs. just 4.2 years for those patients with unmutated IGHV. Disease progression beyond 10 years was relatively uncommon, with only 9% of patients with mutated IGHV developing progression after the 10-year mark. Other malignancies (excluding Richter transformation) developed in 32% of patients, and 6.3% developed therapy-related myeloid neoplasms, which had a high fatality rate (84%). Importantly, no pre-treatment characteristics were predicted for the development of therapy-related myeloid neoplasm. Therefore, the authors conclude that FCR remains a reasonable therapeutic option for patients with CLL with mutated IGHV.