Management of patients with previously untreated chronic lymphocytic leukaemia with obinutuzumab and chlorambucil

Intern Med J. 2017 Jul:47 Suppl 4:5-10. doi: 10.1111/imj.13493.

Abstract

Patients with chronic lymphocytic leukaemia (CLL) are generally older, with many considered 'unfit' for fludarabine-cyclophosphamide-rituximab therapy. In these patients, the combination of obinutuzumab-chlorambucil may be an appropriate therapeutic choice. Obinutuzumab-chlorambucil has been demonstrated to improve overall survival rates compared to chlorambucil alone and to improve progression-free survival and overall response rates compared to rituximab-chlorambucil. This combination can lead to certain toxicities that need to be addressed through appropriate patient selection, pre-medication and management. In this paper, we discuss evidence-based and author-recommended practical management of first-line CLL patients receiving obinutuzumab-chlorambucil.

Keywords: CLL; anti-CD20; monoclonal antibody; obinutuzumab; rituximab.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols
  • Chlorambucil / therapeutic use*
  • Disease-Free Survival
  • Evidence-Based Medicine
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality
  • Patient Selection
  • Practice Guidelines as Topic
  • Remission Induction / methods

Substances

  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents, Immunological
  • Chlorambucil
  • obinutuzumab