{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T11:42:13Z","timestamp":1696419733424},"reference-count":18,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,7,2]],"date-time":"2014-07-02T00:00:00Z","timestamp":1404259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label \/><jats:p>Fludarabine\u2010based regimens are highly effective as first\u2010line therapy in patients with follicular lymphoma. Nevertheless, noticeable haematological toxicity has been reported using fludarabine\u2010based regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To analyse the combination of low\u2010dose oral fludarabine and cyclophosphamide plus rituximab (<jats:styled-content style=\"fixed-case\">FCR<\/jats:styled-content>) as induction therapy, followed by rituximab as maintenance therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analysed 73 patients diagnosed with low\u2010grade follicular lymphoma treated with two different schemes: attenuated oral (<jats:styled-content style=\"fixed-case\">AO<\/jats:styled-content>) and standard intravenous (<jats:styled-content style=\"fixed-case\">SIV<\/jats:styled-content>) <jats:styled-content style=\"fixed-case\">FCR<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall response rate (<jats:styled-content style=\"fixed-case\">ORR<\/jats:styled-content>) was 95% (complete response rate, <jats:styled-content style=\"fixed-case\">CRR<\/jats:styled-content> 79.5%, partial response, <jats:styled-content style=\"fixed-case\">PR<\/jats:styled-content> 15.4%). <jats:styled-content style=\"fixed-case\">CRR<\/jats:styled-content> was 84.6% in <jats:styled-content style=\"fixed-case\">AO<\/jats:styled-content> vs. 61.9% in <jats:styled-content style=\"fixed-case\">SIV<\/jats:styled-content> (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.058). 44.4% of patients underwent maintenance therapy. Grade 3\u20134 toxicities included neutropenia: 65.4%; anaemia: 39.7%; thrombocytopenia: five patients; infectious complications: six patients. There were no treatment\u2010related deaths. 6.8% had a secondary malignancy. Progression\u2010free survival (<jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content>) was 84.6% at 12\u00a0yr. The following variables influenced <jats:styled-content style=\"fixed-case\">PFS<\/jats:styled-content> in multivariate analysis: Hb\u00a0&lt;\u00a012\u00a0g\/dL [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 4.7 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.18\u201318.6)], response after induction [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 4.9 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.01\u201324)] for <jats:styled-content style=\"fixed-case\">PR<\/jats:styled-content> vs. <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content> and [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 21.27 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 4.33\u2013104)] for <jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">DP<\/jats:styled-content> vs. <jats:styled-content style=\"fixed-case\">CR<\/jats:styled-content>. <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> was 83.1% at 12\u00a0yr. The following variables significantly influenced <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> in multivariate analysis: not receiving rituximab as maintenance therapy (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 10.7 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.4\u201382.5), increased levels of <jats:italic>\u03b2<\/jats:italic>2\u2010microglobulin [<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 5.2 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.16\u201323.7)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">FCR<\/jats:styled-content> allowed us to obtain a high response rate, which translated into promising progression free and overall survival with an acceptable and manageable toxicity profile, especially with the attenuated oral scheme.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.12384","type":"journal-article","created":{"date-parts":[[2014,5,22]],"date-time":"2014-05-22T13:04:05Z","timestamp":1400763845000},"page":"469-475","source":"Crossref","is-referenced-by-count":6,"title":["Fludarabine, cyclophosphamide and rituximab as first\u2010line treatment in patients with newly diagnosed follicular lymphoma"],"prefix":"10.1111","volume":"93","author":[{"given":"F\u00e1tima","family":"De la Cruz Vicente","sequence":"first","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo Instituto de Biomedicina de Sevilla (IBIS)\/CSIC\/Universidad de Sevilla Sevilla Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estrella","family":"Carrillo\u2010Cruz","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen del Roc\u00edo Instituto de Biomedicina de Sevilla (IBIS)\/CSIC\/Universidad de Sevilla Sevilla 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