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What Is The Treatment For Choice For CLL?

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Posted on Mon, 3 Nov 2014
Question: For first line CLL therapy, PCR may be preferred over FCR or FR because
A. pentostain trends to cause less myelosuppressions that fludarabine
B. patients are more likely to become refractory to fludarabinethan to pentostatin
C. rituximab and penostatin target the same receptors on B cells
D. pentostain is a purine analog whereas fludarabine ia a pyrimidine analog

Among other characteristics Patient LRwas diagnosed with CLL because he had

A. lymphocytes positive fo CD5 and negative for CD 23
B. sustained lymphocytosis of 14.8 X 109 cells/L not explained by other disorders
C. immature lymphocytes in his blood smear
D. <10% of tumor cell in G0 stage of the cell cycle

What agents are currently considered the treatment of choice for first-line therapy of CLL?
doctor
Answered by Dr. Monish De (35 minutes later)
Brief Answer:
rituximab

Detailed Answer:
Hi

For first line CLL therapy, PCR may be preferred over FCR or FR because pentostain trends to cause less myelosuppressions that fludarabine.

Patient was diagnosed with CLL because lymphocytes positive fo CD5 and negative for CD 23.

First line therapy of CLL include rituximab, alemtuzumab and ofatumumab.

Regards

DR De

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Monish De (2 hours later)
I understand the answer you selected. I too selected C for this answer but it was wrong. Can you give further clarification as to why this is correct
doctor
Answered by Dr. Monish De (11 hours later)
Brief Answer:
severe myelosuppression caused by fludarabine

Detailed Answer:
Hi

For the first question my answer is A that is pentostain trends to cause less myelosuppressions that fludarabine because fludarabine causes severe myelosuppression and may cause severe infection and febrile neutropenia after chemotherapy.

For the second question the answer should be B that is sustained lymphocytosis of 14.8 X 109 cells/L not explained by other disorders.

CLL is CD5 and CD 23 positive and mature lymphocytes are seen in blood smear.

Regards

DR De
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Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Monish De

Oncologist

Practicing since :2004

Answered : 2229 Questions

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What Is The Treatment For Choice For CLL?

Brief Answer: rituximab Detailed Answer: Hi For first line CLL therapy, PCR may be preferred over FCR or FR because pentostain trends to cause less myelosuppressions that fludarabine. Patient was diagnosed with CLL because lymphocytes positive fo CD5 and negative for CD 23. First line therapy of CLL include rituximab, alemtuzumab and ofatumumab. Regards DR De