Younger patients with chronic lymphocytic leukemia benefit from rituximab treatment: A single center study in China

Chronic lymphocytic leukemia (CLL) is characterized by high heterogeneity in clinical features and outcomes in Western countries and China. In this study, the clinical and laboratory data of 210 CLL patients who were admitted to a single center in China between 2002 and 2011 were retrospectively analyzed. CLL patients had a median age of 60.2 years (range, 35-92 years) and CLL occurred more often in elderly female patients than in male patients (female:male, 1.2:1). The overall response rate [ORR, complete remission (CR) + partial remission (PR)] in the entire cohort of patients was 69.5% and the median overall survival (OS) was 67 months (95% CI, 57.88-76.11). In univariate analysis, an age of >60 years, chromosome 17p deletion (17p^-) and elevated β2-MG were associated with a worse OS. Patients with all three poor prognostic factors had a worse outcome than patients with only one or two factors. Patients with 17p^- had a significantly lower ORR (P=0.008) and shorter OS (P=0.001) than those without 17p^-. Rituximab (R)-based treatment was able to overcome the poor prognosis associated with 17p^-. Moreover, the addition of R to fludarabine (F) and cyclophosphamide (C) treatment significantly improved the OS (P=0.012) compared with FC alone in younger patients. However, there were no significant benefits for older patients (P=0.07). This implies that the age of a patient is important in their response to therapy and survival.