%A Autore,Francesco %A Innocenti,Idanna %A Corrente,Francesco %A Del Principe,Maria Ilaria %A Rosati,Serena %A Falcucci,Paolo %A Fresa,Alberto %A Conte,Esmeralda %A Limongiello,Maria Assunta %A Renzi,Daniela %A De Padua,Laura %A Andriani,Alessandro %A Pisani,Francesco %A Cimino,Giuseppe %A Tafuri,Agostino %A Montanaro,Marco %A Mauro,Francesca Romana %A Del Poeta,Giovanni %A Laurenti,Luca %D 2020 %J Frontiers in Oncology %C %F %G English %K chronic lymphocytic leukemia,Elderly,bendamustine,Chlorambucil,rituximab %Q %R 10.3389/fonc.2020.00848 %W %L %M %P %7 %8 2020-June-10 %9 Original Research %# %! CLL front-line therapy for elderly %* %< %T Front-Line Therapy for Elderly Chronic Lymphocytic Leukemia Patients: Bendamustine Plus Rituximab or Chlorambucil Plus Rituximab? Real-Life Retrospective Multicenter Study in the Lazio Region %U https://www.frontiersin.org/articles/10.3389/fonc.2020.00848 %V 10 %0 JOURNAL ARTICLE %@ 2234-943X %X Previous studies investigated the efficacy and the safety of bendamustine (B) vs. chlorambucil (Chl) associated with rituximab (R) in fludarabine-ineligible patients with treated and untreated chronic lymphocytic leukemia (CLL). We conducted a retrospective multicenter study in the Lazio region to further evaluate and compare the efficacy and the toxicity of Chl-R and B-R regimen in CLL patients over the age of 65. We enrolled 192 untreated CLL patients: 111 treated with B-R and 81 with Chl-R. The overall response rates (ORR; 93.6% in B-R and 86.5% in Chl-R) were not statistically different between the two groups, such as progression-free survival (PFS), time to retreatment (TTR), and overall survival (OS). The B-R group showed a higher hematological (p = 0.007) and extra-hematological (p = 0.008) toxicity. When comparing the toxicities according to age, we noted that the extra-hematological toxicity was higher in patients over the age of 75 who were treated with B-R than those treated with Chl-R (p = 0.03). This retrospective study confirms the feasibility of B-R and Chl-R in elderly untreated CLL patients. Currently, patients who are over 75 and unfit are usually treated with Chl-R. This scheme allows achieving the same ORR, PFS, TTR, and OS when compared with B-R because of hematological and extra-hematological toxicities due to B, in which a greater dose reduction has been shown in comparison to Chl.