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  • Title: Rituximab, fludarabine, and cyclophosphamide versus fludarabine and cyclophosphamide for treatment of chronic lymphocytic leukemia: A systematic review with meta-analysis.
    Author: Nunes AA, da Silva AS, Souza KM, Koury Cde N, de Mello LM.
    Journal: Crit Rev Oncol Hematol; 2015 Jun; 94(3):261-9. PubMed ID: 25797826.
    Abstract:
    BACKGROUND: Chronic lymphocytic leukemia (CLL) is a disease of the lymphoid system, in which the most common therapy is fludarabine plus cyclophosphamide (FC). The addition of rituximab to FC has been used, a combination known as FCR. OBJECTIVES: To perform a systematic review with meta-analysis of clinical trials between 2000 and 2012 comparing FC and FCR in patients with CLL. MATERIAL AND METHODS: Electronic databases were searched using keywords related to the objectives of this review. The outcomes examined were progression-free survival and complete remission. RESULTS: The progression-free survival and the overall survival showed significant difference between the two regimens, with complete remission being more frequent in FCR-treated patients (odds ratio=2.58; 95% CI: 2.13-3.13). Patients treated with FCR showed significantly higher neutropenia and serious adverse reactions. CONCLUSION: Despite the favorable results of the FCR regimen on outcomes including complete remission, progression-free survival, and overall survival, there is a lack of methodological rigor and appropriate analyses in many of these studies, and thus, there is a need for further studies examining the effect of rituximab in CLL patients.
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