(HealthDay News) — For patients with previously untreated chronic lymphocytic leukemia (CLL) and coexisting conditions, combining an anti-CD20 antibody (rituximab or obinutuzumab) with chemotherapy is associated with improved outcomes, according to a study published online Jan. 8 in the New England Journal of Medicine.

Valentin Goede, MD, from the University Hospital Cologne in Germany, and colleagues compared the benefit of obinutuzumab versus rituximab, each combined with chlorambucil, in 781 patients (median age, 73 years) with previously untreated CLL. Each patient had a score higher than 6 on the Cumulative Illness Rating Scale or an estimated creatinine clearance of less than 70 mL per minute.

The researchers found that, compared with chlorambucil monotherapy, treatment with obinutuzumab-chlorambucil or rituximab-chlorambucil correlated with increased response rates. Compared with chlorambucil monotherapy, progression-free survival was prolonged for obinutuzumab-chlorambucil (26.7 versus 11.1 months; hazard ratio [HR], 0.18) and for rituximab-chlorambucil (16.3 versus 11.1 months; HR, 0.44).

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Compared with chlorambucil alone, obinutuzumab-chlorambucil was associated with prolonged overall survival (HR, 0.41). Progression-free survival was prolonged for obinutuzumab-chlorambucil versus rituximab-chlorambucil (HR, 0.39) and there were also higher rates of complete response (20.7% versus 7.0%) and molecular response.

“Combining an anti-CD20 antibody with chemotherapy improved outcomes in patents with CLL and coexisting conditions,” the researchers wrote. “Obinutuzumab was superior to rituximab, when each was combined with chlorambucil, in this patient population.”

The study was funded by F. Hoffmann-La Roche.


  1. Goede V, Fischer K, Busch R, et al. Obinutuzumab plus Chlorambucil in Patients with CLL and Coexisting Conditions. N Engl J Med. 2014;doi:10.1056/NEJMoa1313984.