Naslov
COLLABORATIVE META-ANALYSIS OF RANDOMISED TRIALS IN CHRONIC LYMPHOCYTIC LEUKAEMIA (CLL)

Autori
Binet, J.L. ; Dighiero, G. ; Catovsky, D. ; Hansen, M. ; Jakšić, Branimir ; Kimby, E. ; Montserrat, E. ; Richards, S. ; Wiernik, P.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
British Journal of Haematology / - , 1998

Skup
ISH-EHA Combined Haematology Congress

Mjesto i datum
Amsterdam, Nizozemska, 04.07.1998. - 08.07.1998

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Sažetak
It has been difficult to assess the relative effects of immediate versus deferred treatment for early stage CLL, and of combination chemo-therapy versus chlorambucil for later stage disease. A systematic review, involving a collaborative meta-analysis, was performed to obtain reliable estimates of these effects. Individual patient data were sought for all relevant randomised trials, and were centrally checked and analysed. Six trials, involving 2000 patients with early CLL, randomised deferred treatment versus immediate treatment with chlorambucil or chlorambucil plus a steroid. 10-year survival was 44% with immediate versus 47% with deferred treatment (difference = 3% with standard deviation (SD) 3% ; non-significant (NS)). Fewer than 400 patients in any stage have been randomised in trials of chlorambucil versus chlorambucil plus a steroid. Survival was similar with both treatments. Four trials, involving 760 patients, randomised COP (cyclophosphamide, vincristine plus prednisone) versus chlorambucil (with or without a steroid), and five trials, involving 840 patients, randomised CHOP (COP plus doxo-rubicin) versus chlorambucil (with or without a steroid). There was no evidence of any difference between individual trials in their estimate of the relative effect of these treatments and, overall, 5-year survival was 48% SD 2% both with combination chemo-therapy and with chlorambucil. These results suggest that treatment of early stage disease should be deferred until necessitated by symptoms, and that when treatment is required, there may well be little or no advantage to using combination chemo-therapy instead of chlorambucil.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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