Chlorambucil-prednisone (C+P)
Checked 2026-09-09
Historic first-line treatment for symptomatic, advanced chronic lymphocytic leukaemia, given every two weeks and continued to maximal response; superseded by fludarabine combinations, chlorambucil-obinutuzumab and the BTK and BCL2 inhibitors
Also called Chlorambucil and prednisone, C+P, CHLORAMBUCIL-PREDNISONE, Intermittent chlorambucil-prednisone.
One cycle
every 14 daysComponents
| Drug | Dose | Route | Days | Note |
|---|---|---|---|---|
Chlorambucil Alkylating agent (nitrogen mustard) | 30 mg/m² | Oral | D1 | |
Prednisone Glucocorticoid | 80 mg once daily | Oral | D1-5 |
Cycles
to maximal response, up to 18 months
14-day cycle
Emetogenicity
Low (10-30%)
G-CSF
Not routine
Notes
- In the ECOG trial of 122 patients, C+P and the more intensive CVP gave the same survival, complete remission rate and duration of response, so the gentler regimen stayed the standard for advanced CLL in the 1990s.
- Continuing treatment until the best response, rather than intensifying it, was credited with the long survival seen; toxicity was modest despite prolonged treatment.
- Today chlorambucil survives mainly as the chemotherapy partner of obinutuzumab (CLL11) and as a comparator in trials of targeted drugs.
Used in
Products
Source
Raphael (ECOG), JCO 1991: intermittent chlorambucil-prednisone versus CVP in advanced CLL
Reference doses for a typical adult from the cited protocol or label. Doses are adjusted for renal and hepatic function, age, performance status and prior toxicity, and institutional protocols vary. Verify against the current label and your local protocol before treating. Not medical advice.