Is the CHOP Regimen a Good Treatment for Advanced CLL? Results from two Randomized Clinical Trials

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Abstract
Between 1985 and 1990, the French Cooperative Group on Chronic Lymphocytic Leukemia (CLL) randomized 287 stage B patients between intermittent chlorambucil plus prednisone (n = 140) or CHOP (n = 147), and 90 stage C patients between CHOP (n = 44) or CHOP plus methotrexate (n = 46). In stage B, although treatment response was improved with CHOP (p = 0.007, chi-square test), no difference in survival was observed between the two randomized groups (p = 0.33, score test). In stage C, no differences in treatment response and survival were shown, with median survival close to that reported with CHOP in the previous CLL-80 trial. These results associated with those from other groups raise the question whether the CHOP regimen, which has been consistently shown to improve response to therapy, is an effective treatment in advanced CLL patients.