1. Dose-dense high-dose methylprednisolone and rituximab in the treatment of relapsed or refractory high-risk chronic lymphocytic leukemia
- Author
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Mindaugas Stoškus, Jurgita Sejoniene, Laimonas Griskevicius, Vilma Valceckiene, Regina Pileckyte, Mindaugas Jurgutis, Egle Gineikiene, Tadas Zvirblis, and Andrius Degulys
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Chronic lymphocytic leukemia ,High dose methylprednisolone ,Gastroenterology ,Methylprednisolone ,Drug Administration Schedule ,Antibodies, Monoclonal, Murine-Derived ,Refractory ,Risk Factors ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Prospective Studies ,Aged ,Chromosome Aberrations ,Dose-Response Relationship, Drug ,business.industry ,Hematology ,Middle Aged ,medicine.disease ,Prognosis ,Leukemia, Lymphocytic, Chronic, B-Cell ,Survival Analysis ,Surgery ,Fludarabine ,Blood Cell Count ,Treatment Outcome ,Oncology ,Drug Resistance, Neoplasm ,Hyperglycemia ,Toxicity ,Mutation ,Rituximab ,Female ,Neoplasm Recurrence, Local ,Tumor Suppressor Protein p53 ,Trisomy ,business ,medicine.drug ,Follow-Up Studies - Abstract
This study evaluated the efficacy and safety of dose-dense high-dose methylprednisolone (HDMP) plus rituximab (Rtx) in patients with high-risk CLL. Twenty-nine patients with relapsed or progressive CLL with adverse cytogenetics (17p deletion, TP53 mutation, 11q deletion, and/or trisomy 12) and/or progression within 12 months of fludarabine treatment were included. HDMP (1 g/m(2)) was administered daily for 5 days of each treatment course. Rtx was administered on days 1 (375 mg/m(2)) and 5 (500 mg/m(2)) of the first treatment course, on days 1 (500 mg/m(2)) and 5 (500 mg/m(2)) of the second course, and on day 1 (500 mg/m(2)) of courses 3-6. The cycles were repeated every 21 days. The overall response rate (ORR) was 62%, and 28% of patients had stable disease. In 13 patients with 17p deletion/TP53 mutation, ORR was 69%. After 22 months, the median progression-free and overall survivals were 12 and 31 months, respectively. The most frequent toxicity was hyperglycemia, and three deaths occurred in the study. Dose-dense treatment with HDMP and Rtx is an effective therapy with a favorable safety profile in patients with high-risk CLL, including those with 17p deletion/TP53 mutation.
- Published
- 2011