Cyclophosphamide, alvocidib (flavopiridol), and rituximab, a novel feasible chemoimmunotherapy regimen for patients with high-risk chronic lymphocytic leukemia.

Stephens, Deborah M; Ruppert, Amy S; Maddocks, Kami; Andritsos, Leslie; Baiocchi, Robert; Jones, Jeffrey; Johnson, Amy J; Smith, Lisa L; Zhao, Yuan; Ling, Yonghua; Li, Junan; Phelps, Mitch A; Grever, Michael R; Byrd, John C; Flynn, Joseph M

Stephens, Deborah M; Ruppert, Amy S; Maddocks, Kami; Andritsos, Leslie; Baiocchi, Robert; Jones, Jeffrey; Johnson, Amy J; Smith, Lisa L; Zhao, Yuan; Ling, Yonghua; Li, Junan; Phelps, Mitch A; Grever, Michael R; Byrd, John C; Flynn, Joseph M.

Afiliación

Stephens DM; Division of Hematology, Department of Internal Medicine, The Ohio State University, Columbus, OH 43210, United States. deborah.stephens@osumc.edu

Leuk Res ; 37(10): 1195-9, 2013 Oct.

Article en En | MEDLINE | ID: mdl-23867058

RESUMEN

Alvocidib has demonstrated efficacy in high-risk chronic lymphocytic leukemia (CLL) patients. In this phase I study, we combined cyclophosphamide, alvocidib and rituximab (CAR) in a schema designed to mitigate tumor lysis syndrome (TLS) seen previously with alvocidib. Nine nucleoside analog-naïve, high-risk patients received escalating doses of CAR therapy. Dose limiting toxicity was not experienced. No instances of TLS were observed. Patient responses included three complete remissions and four partial remissions. CAR was tolerable and active in high-risk CLL patients without TLS toxicity. With continued monitoring of toxicities, a phase Ib/II study of this combination as frontline therapy is warranted.

Asunto(s)

Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico; Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico; Adulto; Anciano; Anticuerpos Monoclonales de Origen Murino/administración & dosificación; Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos; Ciclofosfamida/administración & dosificación; Femenino; Flavonoides/administración & dosificación; Humanos; Leucemia Linfocítica Crónica de Células B/patología; Masculino; Persona de Mediana Edad; Estadificación de Neoplasias; Piperidinas/administración & dosificación; Rituximab; Resultado del Tratamiento

Palabras clave

Alvocidib; B2M; CAR; CDK; CLL; CR; CRS; Chemoimmunotherapy; Chronic lymphocytic leukemia; Cyclin-dependent kinase inhibitor; DLT; Del(11q); Del(17p); ECOG; Eastern Cooperative Oncology Group; FC(R); Flavopiridol; High-risk cytogenetics; IgV(H); MTD; NCI; National Cancer Institute; ORR; OS; PD; PFS; PK; TLS; WBC; beta 2 microglobulin; chronic lymphocytic leukemia; complete response; cyclin-dependent kinase; cyclophophamide, alvocidib, rituximab; cytokine release syndrome; dose limiting toxicity; fludarabine, cyclophosphamide, (rituximab); immunoglobulin heavy chain variable region; maximum tolerated dose; overall response rate; overall survival; pharmacokinetic; progression-free survival; progressive disease; tumor lysis syndrome; white blood cell

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Protocolos de Quimioterapia Combinada Antineoplásica Tipo de estudio: Etiology_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Leuk Res Año: 2013 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

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