AUTHOR=Autore Francesco , Innocenti Idanna , Corrente Francesco , Del Principe Maria Ilaria , Rosati Serena , Falcucci Paolo , Fresa Alberto , Conte Esmeralda , Limongiello Maria Assunta , Renzi Daniela , De Padua Laura , Andriani Alessandro , Pisani Francesco , Cimino Giuseppe , Tafuri Agostino , Montanaro Marco , Mauro Francesca Romana , Del Poeta Giovanni , Laurenti Luca TITLE=Front-Line Therapy for Elderly Chronic Lymphocytic Leukemia Patients: Bendamustine Plus Rituximab or Chlorambucil Plus Rituximab? Real-Life Retrospective Multicenter Study in the Lazio Region JOURNAL=Frontiers in Oncology VOLUME=Volume 10 - 2020 YEAR=2020 URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.00848 DOI=10.3389/fonc.2020.00848 ISSN=2234-943X ABSTRACT=Previous studies investigated efficacy and safety of Bendamustine (B) vs Chlorambucil (Chl) associated with Rituximab (R) in Fludarabine-ineligible patients with treated and untreated CLL. We conducted a retrospective multicenter study in the Lazio region to further evaluate and compare efficacy and toxicity of Chl-R and B-R regimen in CLL patients over the age of 65. We enrolled 192 untreated CLL patients, 111 treated with B-R and 81 with Chl-R. The ORR (93.6% in B-R and 86.5% in Chl-R) was not statistically different between the two groups, such as PFS, TTR and OS. B-R group showed a higher haematological (p=0.007) and extra-haematological (p=0.008) toxicity. When comparing toxicities according to age, we noted that extra-haematological toxicity was higher in patients over the age of 75 who were treated with B-R than those treated with Chl-R (p=0.03). This retrospective study confirms the feasibility of B-R and Chl-R in elderly untreated CLL patients. Currently, patients who are over 75 and unfit are usually treated with Chl-R. This scheme allows to achieve the same ORR, PFS, TTR and OS when compared with B-R because of haematological and extra-haematological toxicities due to B, in which a greater dose reduction has been shown in comparison to Chl.