Fludarabine in chronic lymphocytic leukaemia

Abstract

Chronic lymphocytic leukaemia (CLL) is the most common leukaemia in the Western world. Historically, CLL patients have received prednisone- or chlorambucil-containing regimens, resulting in modest responses and a slim chance of long-term survival. The addition of purine nucleoside analogues, specifically fludarabine, to the armamentarium has significantly improved efficacy in treatment-naive or heavily pretreated CLL patients. Since the 1980s, fludarabine monotherapy has demonstrated an improvement in response over historical chemotherapeutic agents. Single-agent fludarabine therapy has expanded into a combination regimen containing cyclophosphamide and has further evolved to incorporate monoclonal antibodies. A review of the fludarabine literature shows that these advancements in fludarabine-containing therapy have enhanced the overall patient response with a potential increase in survival time, thus representing progress towards a superior treatment for CLL.

Keywords::

• chronic lymphocytic leukaemia
• fludarabine
• purine nucleoside analogue

Acknowledgements

The authors would like to acknowledge the contribution of Meniscus Healthcare Communications in the preparation of this manuscript. This work is supported in part by Schering Pharmaceuticals.