NICE technology appraisal guidance
Issued: September 2001
TA29

Guidance on the use of fludarabine for B-cell chronic lymphocytic leukaemia

This is an extract from the guidance and may be misleading if read alone. The complete guidance is available at guidance.nice.org.uk/ta29

1 Guidance

1.1 Oral fludarabine is recommended as second line therapy for B-cell chronic lymphocytic leukaemia (CLL) for patients who have either failed, or are intolerant of, first line chemotherapy, and who would otherwise have received combination chemotherapy of either:

1.1.1 cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP)

1.1.2 cyclophosphamide, doxorubicin and prednisolone (CAP) or

1.1.3 cyclophosphamide, vincristine and prednisolone (CVP)

1.2 The oral formulation of fludarabine is preferred to the intravenous formulation on the basis of more favourable cost effectiveness. Intravenous fludarabine should only be used when oral fludarabine is contra-indicated.