Patients with chronic lymphocytic leukemia (CLL) who harbor mutated IGHB genes without either 11q or 17p are likely to have durable remission after frontline fludarabine, cyclophosphamide, and rituximab (FCR), according to an Italian study published in Blood.

“In the new scenario of targeted agents, there is an increasing interest in identifying patients who gain the maximum benefit from FCR,” noted researchers led by Davide Rossi, MD, PhD, of the Amedeo Avogadro University of Eastern Piedmont, in Italy.

In an observational, multicenter, retrospective analysis of 404 patients with CLL who received frontline FCR, the researchers were able to identify low-risk patients who carried mutated IGHV genes but neither 11q or 17p deletion – the combination of which are widely tested before treatment.

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Low-risk patients accounted for 28% of all cases, and most of them (71%) remained progression-free after treatment with a lower risk of relapse after 4 years of FCR.

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Life expectancy of very low-risk patients (91% at 5 years) was found to be super-imposable to the general population, suggesting that neither the disease nor complications from treatment had any effect on survival in low-risk patients.

“These findings need a prospective validation and may be helpful for the design of clinical trials aimed at comparing FCR to new targeted treatments of CLL, and, possibly, for optimized disease management,” the authors concluded.


  1. Rossi D, Terzi-di-Bergamo L, De Paoli L, et al. Molecular prediction of durable remission after first line fludarabine-cyclophosphamide-rituximab in chronic lymphocytic leukemia. Blood. 2015. [epub ahead of print]. doi: