{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T14:42:07Z","timestamp":1778337727869,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,10]],"date-time":"2020-08-10T00:00:00Z","timestamp":1597017600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002706","name":"AFA F\u00f6rs\u00e4kring","doi-asserted-by":"publisher","award":["130054"],"award-info":[{"award-number":["130054"]}],"id":[{"id":"10.13039\/501100002706","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Bendamustine\u00a0+\u00a0rituximab (BR) is the current first\u2010line standard\u2010of\u2010care for chronic lymphocytic leukaemia (CLL) in fit patients aged 66\u201370\u00a0years, whereas chlorambucil\u00a0+\u00a0CD20 antibody is recommended in older patients with co\u2010morbidities. This retrospective real\u2010world study investigated whether risk\u2010adapted BR was safe and effective in elderly patients. All 141 CLL patients in the Stockholm region (diagnosed from 2007 to 2016, identified from regional registries) who had received BR as first (<jats:italic>n<\/jats:italic>\u00a0=\u00a084) or later line (<jats:italic>n<\/jats:italic>\u00a0=\u00a057) were analysed. Median age was 72\u00a0years, 49% had Binet stage C, 40% had Cumulative Illness Rating Scale (CIRS) score\u00a0\u2265\u00a06, 20% Eastern Cooperative Oncology Group (ECOG) score 2. None had del(17p). Only 15% of patients aged \u226580\u00a0years received full\u2010dose bendamustine and 65% of them postponed rituximab until cycle 2. Corresponding numbers in patients 73\u201379\u00a0years were 21% and 36% and in &lt;73\u00a0years, 63% and 33%. Overall response rate was 83% (first line) and 67% (later line) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b7022) equally distributed between age subsets. ECOG, immunoglobulin heavy chain variable region (<jats:italic>IGHV<\/jats:italic>) mutational status and cytogenetics, but not treatment line and age, were significant factors on progression\u2010free survival (PFS) in multivariate analysis. Infections and neutropenia\/thrombocytopenia (\u2265grade 3) were similar across age subgroups. In summary, BR was well tolerated even in patients \u226580\u00a0years, with similar efficacy and safety as in less old patients, provided that carefully adapted dosing was applied.<\/jats:p>","DOI":"10.1111\/bjh.17032","type":"journal-article","created":{"date-parts":[[2020,8,11]],"date-time":"2020-08-11T06:00:31Z","timestamp":1597125631000},"page":"426-432","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Risk\u2010adapted bendamustine\u00a0+\u00a0rituximab is a tolerable treatment alternative for elderly patients with chronic lymphocytic leukaemia: a regional real\u2010world report on 141 consecutive Swedish patients"],"prefix":"10.1111","volume":"191","author":[{"given":"Agnes","family":"Mattsson","sequence":"first","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Internal Medicine S\u00f6dersjukhuset Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra E.","family":"Sylvan","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Asklid","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Oncology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Wiggh","sequence":"additional","affiliation":[{"name":"Department of Hematology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0905-2424","authenticated-orcid":false,"given":"Maria","family":"Winqvist","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Hematology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanette","family":"Lundin","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Hematology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larry","family":"Mansouri","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Rosenquist","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hemming","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"\u00d6sterborg","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Hematology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6614-5737","authenticated-orcid":false,"given":"Lotta","family":"Hansson","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2010Pathology Karolinska Institutet Stockholm Sweden"},{"name":"Department of Hematology Karolinska University Hospital Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdv303"},{"key":"e_1_2_9_3_1","unstructured":"Regionalt Cancercentrum.Nationella v\u00e5rdprogrammet f\u00f6r kronisk lymfatisk leukemi (KLL).2019. Available from:https:\/\/www.cancercentrum.se\/syd\/cancerdiagnoser\/blod\u2010lymfom\u2010myelom\/kronisk\u2010lymfatisk\u2010leukemi\u2010kll\/vardprogram\/."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61381-5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.20.8389"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313984"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.2688"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(16)30051-1"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2017.170480"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2018.200204"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1995.tb06377.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/leu.2017.125"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-093906"},{"key":"e_1_2_9_14_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1200\/PO.17.00157","article-title":"Use of real\u2010world data for the research, development, and evaluation of oncology precision medicines","author":"Lewis JRR","year":"2017","journal-title":"JCO Precis Oncol"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60027-7"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2016.03.069"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2015.07.009"},{"key":"e_1_2_9_18_1","doi-asserted-by":"crossref","unstructured":"SharmanJP BanerjiV FogliattoLM HerishanuY MunirT WalewskaR et al.LBA\u20101 a randomized phase 3 trial of blinatumomab vs. chemotherapy as post\u2010reinduction therapy in high and intermediate risk (HR\/IR) first relapse of B\u2010acute lymphoblastic leukemia (B\u2010ALL) in children and adolescents\/young adults (AYAs) demonstrates superior efficacy and tolerability of blinatumomab: a report from Children\u2019s Oncology Group Study AALL1331.ASH Annual Meeting Abstract31.2019.","DOI":"10.1182\/blood-2019-132435"}],"container-title":["British Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbjh.17032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.17032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/bjh.17032","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bjh.17032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,11]],"date-time":"2024-08-11T16:32:40Z","timestamp":1723393960000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/bjh.17032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,10]]},"references-count":17,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/bjh.17032"],"URL":"https:\/\/doi.org\/10.1111\/bjh.17032","archive":["Portico"],"relation":{},"ISSN":["0007-1048","1365-2141"],"issn-type":[{"value":"0007-1048","type":"print"},{"value":"1365-2141","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,10]]},"assertion":[{"value":"2020-07-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}