Retreatment with purine analogs in patients with chronic lymphocytic leukemia

We evaluated the efficacy and toxicity of retreatment with purine analogs (PA) in 62 patients with relapsed chronic lymphocytic leukemia. Median OS and PFS after retreatment were 60 and 26 months, respectively. By multivariate analysis, minimal residual disease status, ZAP-70 expression and age had independent predictive power in terms of OS. Toxicity was mainly neutropenia (21%) and infections (39%). Second malignancies were observed in 10 (16%) patients. Our results outline that retreatment with PA is remarkably effective in patients with relapsed CLL, but with a significant toxicity.