Fludarabine Versus Fludarabine Plus Cyclophosphamide

The observation of higher than expected response rates with the combination of FLU with cyclophosphamide (CTX)3 prompted prospective, randomized trials of the combination compared to FLU alone. These studies consistently demonstrated improved response rates and longer PFS for the combination treatment.4 Although toxicities were increased and there was no improvement in overall survival with the combination, the improved response rates and prolonged PFS strongly suggest that in patients able to tolerate intensive therapy, the combination of FLU plus CTX is preferred to FLU alone.

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