Maintenance Therapy in Chronic Lymphocytic Leukemia

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Maintenance therapy has demonstrated some utility as a treatment for patients with chronic lymphocytic leukemia (CLL); however, its true benefit remains debatable. In two studies of CD20 monoclonal antibodies presented at the ASH Annual Meeting, an improvement in PFS was seen but not overall survival, when maintenance was compared with observation. However, efficacy benefits were offset by the adverse events experienced by patients on the maintenance treatments.

Maintenance therapy could be used in patients who have only a partial response and tend to have a higher risk of progression, suggests Shou Ma, MD, PhD. It might be appropriate to wait and see if patients need therapy, since responses can be seen in the bone marrow 6 months after stopping frontline treatment, Thomas J. Kipps, MD, explains.

Caution should be exercised when integrating maintenance rituximab or ofatumumab after frontline therapy, Myron Czuczman, MD, recommends. More data and follow-up is necessary before these maintenance strategies become a standard practice.