Matrix Science Pharma (MSP)

ABSTRACT

Background: Chlorambucil was the standard of care therapy in chronic lymphocytic leukemia (CLL), it becomes restricted for a specific type of CLL population, due to the launching of more effective anticancer agents. However, in Sudan, chlorambucil remains the first‑line therapy in CLL. Thus, the study aimed to determine the effectiveness of chlorambucil in Sudanese CLL patients who attended the Khartoum Oncology Hospital from January 2014 to October 2017. Methods: This was a descriptive retrospective hospital‑based study in which files of patients who met the inclusion criteria were critically reviewed using a data collection sheet. The main response indicative parameters were lymphocytes count, lymph node enlargement, and organomegaly status. Effectiveness was assessed by measuring the overall response rate (ORR) as the primary endpoint and the progression‐free survival (PFS) as the secondary endpoint. Results: A total of 64 patients were included, 62.5% of them were male. The majority of them (59.4%) were aged ≥65 years old. Clinically, 43.8% of these patients were at stage IV. Around 63.1% of the patients received high dosages of chlorambucil. The median PFS for chlorambucil was 18 months. The complete clinical and partial remission rates were 24.4% and 20%, respectively. The ORR was significantly higher with the higher dose of chlorambucil (P = 0.019). While in terms of PFS, there was an insignificant difference between high dose (15 months) and small dose (22 months) of chlorambucil. Conclusion: In CLL Sudanese patients, chlorambucil was shown to have low response rates. High doses of chlorambucil lead to induction of better ORR, but there was no additional benefit in PFS compared to those who received low doses of chlorambucil.