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Tam et al report long-term data from 300 CLL patients treated with the fludarabine, cyclophosphamide, and rituximab (FCR) regimen. Complete and overall response rates were 72% and 95%, respectively. The median time to progression was 80 months, and six-year overall survival was 77%. Late infection occurred in 10% after the first year of treatment, and almost 19% had persistent cytopenias after treatment. After adjusting for pre-treatment factors, FCR was associated with prolonged survival compared to other fludarabine regimens for initial treatment at the same center. The high activity and prolonged remissions suggest FCR as an excellent front-line regimen for CLL in select patients.
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Three CLL cellular markers have been shown to be of prognostic value in determining those patients likely to have aggressive disease. Of the three, ZAP-70 was shown, in this current report from the CLL Research Consortium, to be the greatest discriminator of need for early treatment. The current value of these markers remains investigational.
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This second publication from the COURAGE investigators reports on multiple assessments of quality of life, particularly angina presence and severity, between the two groups over the study observation.
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Diabetic patients are at higher risk for in-stent restenosis and stent thrombosis than their non-diabetic counterparts.
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The management of anticoagulation in patients requiring long-term warfarin therapy is often problematic when they need cardiac catheterization.
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In patients with elevated triglycerides, other atherogenic particles may be as important as LDL-cholesterol (C). These particles and LDL-C are measured as non-HDL-C, and are considered a secondary target of therapy.
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The relationship between physical activity and atrial fibrillation has been controversial. Lone atrial fibrillation is relatively common in young, competitive athletes, and it is uncertain whether routine physical activity is protective or harmful in elderly populations where atrial fibrillation is more common.
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The sudden cardiac death in heart failure trial (SCD-HeFT) was a study involving patients with ischemic and non-ischemic cardiomyopathy and a left ventricular ejection fraction < 35% and class II or III heart failure that tested the value of ICD therapy for the primary prevention of sudden cardiac death.
