Rituximab in Combination with High-dose Methylprednisolone for the Treatment of Fludarabine Refractory High-risk Chronic Lymphocytic Leukemia
Overview
Affiliations
We examined the clinical response of fludarabine-refractory CLL patients treated with high-dose methylprednisolone (HDMP) and rituximab. Fourteen patients were treated with three cycles of rituximab (375 mg/m(2) weekly for 4 weeks) in combination with HDMP (1 gm/m(2) daily for 5 days). All patients were refractory to fludarabine and 86% had high-risk disease by the modified Rai classification. In all, 79% of the patients had CLL cells that expressed ZAP-70 and three patients had poor prognostic cytogenetics. The overall response rate was 93% and the complete remission rate was 36%. The median time-to-progression was 15 months and the median time-to-next treatment was 22 months. Median survival has not been reached after a median follow up of 40 months. Four patients have died of progressive disease. Patients tolerated the treatment well and serious adverse events were rare. This allowed patients to receive all planned treatments on schedule with no dose modifications. All but one patient responded to treatment and the overall survival and time-to-progression were superior to those of other published salvage regimens.
Current Therapeutic Sequencing in Chronic Lymphocytic Leukemia.
Mouhssine S, Maher N, Kogila S, Cerchione C, Martinelli G, Gaidano G Hematol Rep. 2024; 16(2):270-282.
PMID: 38804280 PMC: 11130833. DOI: 10.3390/hematolrep16020027.
Nguyen T, Nhu N, Tran V, Viet-Nhi N, Ho X, Jhan M Sci Rep. 2023; 13(1):9775.
PMID: 37328530 PMC: 10276018. DOI: 10.1038/s41598-023-36279-x.
Molecular mechanisms contributing to glucocorticoid resistance in lymphoid malignancies.
Scheijen B Cancer Drug Resist. 2022; 2(3):647-664.
PMID: 35582582 PMC: 8992511. DOI: 10.20517/cdr.2019.29.
NKp30 - A prospective target for new cancer immunotherapy strategies.
Pinheiro P, Justino G, Marques M Br J Pharmacol. 2020; 177(20):4563-4580.
PMID: 32737988 PMC: 7520444. DOI: 10.1111/bph.15222.
Harnessing cancer immunotherapy during the unexploited immediate perioperative period.
Matzner P, Sandbank E, Neeman E, Zmora O, Gottumukkala V, Ben-Eliyahu S Nat Rev Clin Oncol. 2020; 17(5):313-326.
PMID: 32066936 DOI: 10.1038/s41571-019-0319-9.