Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies

Laurencet, F; Zulian, Gilbert; Guetty-Alberto, M; Iten, P.A.; Betticher, Daniel; Alberto, P.

doi:10.1038/sj.bjc.6690195

Cited by 48 publications

(32 citation statements)

References 37 publications

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“…[50][51][52][53][54] Because alkylating agents and nucleoside analogues have been shown to be effective, combinations of these agents have been tested, and response rates of 58% to 88% have been observed. [55][56][57] The addition of rituximab to these agents has been well tolerated with little additional toxicity and appears to further increase the response rate. 58-60 Recent studies using the proteasome inhibitor bortezomib in combination with rituximab have found this combination to be effective.…”

Section: Choice Of Initial Therapymentioning

confidence: 99%

Diagnosis and Management of Waldenström Macroglobulinemia: Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines

Ansell

Kyle

Reeder

et al. 2010

Mayo Clinic Proceedings

148

145

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Section: Choice Of Initial Therapymentioning

confidence: 99%

Diagnosis and Management of Waldenström Macroglobulinemia: Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines

Ansell

Kyle

Reeder

et al. 2010

Mayo Clinic Proceedings

148

145

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“…Future approaches to improving the CR rate and remission duration with front-line 2-CdA therapy may involve combination therapy with other chemotherapeutic agents. Several Phase I and II trials have piloted combinations of 2-CdA with mitoxantrone, [40][41][42] cyclophosphamide, 43,44 and chlorambucil. 45 However, in those initial trials, response rates from 28.5% to 90% (CR rate, 7.1-44%) appear similar to single-agent trials, and toxicities may be increased.…”

Section: Discussionmentioning

confidence: 99%

Prolonged follow‐up after initial therapy with 2‐chlorodeoxyadenosine in patients with indolent non‐Hodgkin lymphoma

Blum¹,

Johnson²,

Niedzwiecki³

et al. 2006

Cancer

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A H2O/dimethyl sulfoxide(DMSO) mixture was used as the coagulation bath for the wet‐spun process of acrylonitrile/ammonium itaconate copolymers fibers. Diffusion coefficient of DMSO in the protofibers prepared by acrylonitrile/ammonium itaconate copolymers was determined. It has been found that diffusion coefficient of DMSO outflow of the protofibers prepared by acrylonitrile/ammonium itaconate copolymers synthesized by the solution polymerization is highest compared with those of acrylonitrile/ammonium itaconate copolymers synthesized by H2O/DMSO mixture suspension polymerization and the aqueous suspension polymerization. With an increase of copolymer concentration in the dope, diffusion coefficient of DMSO decreases continuously. Diffusion coefficient of DMSO increases along with the bath temperature, but the changes of diffusion coefficient values are less prominent as temperature goes beyond 60°C. When DMSO concentration in the coagulation bath was 55 wt %, the value of the diffusion coefficient of DMSO was minimal. Diffusion coefficient of H2O increases with the jet stretch minus ratio increasing. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 100: 4447–4451, 2006

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“…In the trials finished to date, alkylating drugs and anthracyclines with mitoxantrone were most often combined with either FAMP or with 2-CdA. [10][11][12][13][14][15][16][17][18]29,30 Our study is the first, to our knowledge, in which previously Table 4 CMC-induced grade III and IV non-hematological side-effects n, number of patients; n1, number of courses; FUO, fever of unknown origin; DIC, disseminated intravascular coagulation; IHD, ischemic heart disease. untreated CLL patients received two other drugs in combination with 2-CdA: cyclophosphamide and mitoxantrone (CMC programme).…”

Section: Discussionmentioning

confidence: 99%

“…10,11 These results have been confirmed recently by early clinical trials, which have shown that the combination of 2-CdA with cyclophosphamide and prednisone is feasible and active in patients with CLL and other low-grade lymphoid malignancies. 13,14 Mitoxantrone is also a useful drug in the treatment of lowgrade lymphomas and can be combined with purine analogs. [17][18][19][20] However, the advantage of such a combination in patients with refractory or relapsing disease over 2-CdA alone has not yet been proven.…”

Section: Introductionmentioning

confidence: 99%

“…Some preclinical studies and early clinical reports may support such a hypothesis. [10][11][12][13][14][15][16] Among cytotoxic agents, alkylating drugs and anthracyclines were the primary candidates for use in combination with purine analogs. Synergistic action of 2-CdA with cyclophosphamide and its derivatives has been shown both in in vitro and in vivo experiments.…”

Section: Introductionmentioning

confidence: 99%

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Cladribine combined with cyclophosphamide and mitoxantrone as front-line therapy in chronic lymphocytic leukemia

et al. 2001

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The objective of the study was to determine the effectiveness and the toxicity of a combined chemotherapy consisting of cladribine (2-CdA), mitoxantrone and cyclophosphamide (CMC regimen) in the treatment of previously untreated B cell chronic lymphocytic leukemia (B-CLL). From August 1998 to December 2000 2-CdA was administered at a dosage of 0.12 mg/kg for 3 (CMC3) or 5 (CMC5) consecutive days, mitoxantrone at 10 mg/m 2 on day 1 and cyclophosphamide at 650 mg/m 2 on day 1 to 62 patients with advanced or progressive B-CLL. The cycles were repeated at 4 week intervals or longer if severe myelosuppression occurred. Twenty patients received CMC5 and 42 patients CMC3. Within the analyzed group an overall response (OR) rate (CR+PR) of 64.5% (95% CI: 52.7-76.3%) was reported, including 29.0% CR. There was no difference in the CR rate between the patients treated with CMC5 (30%) and CMC3 (28.6%) (P = 0.9), nor in the OR rate (55.0% and 69.0%, respectively, P = 0.3). Residual disease was identified in seven out of 18 (38.9%) patients who were in CR, including two treated with CMC5 and five treated with CMC3 protocols. CMC-induced grade III or IV thrombocytopenia occurred in 12 (19.4%) of patients, including four (20%) CMC5-treated and eight (19%) CMC3-treated patients (P = 0.8). Neutropenia grade III or IV was observed in seven (35%) and 11 (26.2%) patients, respectively (P = 0.8). Severe infections, including pneumonia and sepsis, occurred more frequently after CMC5 (11 patients, 55.0%) than CMC3 (10 patients, 28.6%) (P = 0.03) Fourteen patients died, including six treated with CMC5 and eight treated with CMC3 (30% and 19%, respectively). Infections were the cause of death in nine patients, including four in the CMC5 group and five in the CMC3 group. In conclusion, our results indicate that the CMC programme is an active combined regimen in previously untreated B-CLL patients; its efficiency seems to be similar to that observed earlier in B-CLL patients treated with 2-CdA as a single agent. However, toxicity, especially after CMC5 administration, is significant. Therefore, we recommend the CMC3 but not the CMC5 programme for further evaluation. Leukemia (2001Leukemia ( ) 15, 1510Leukemia ( -1516

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Cladribine with cyclophosphamide and prednisone in the management of low-grade lymphoproliferative malignancies

Cited by 48 publications

References 37 publications

Diagnosis and Management of Waldenström Macroglobulinemia: Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines

Diagnosis and Management of Waldenström Macroglobulinemia: Mayo Stratification of Macroglobulinemia and Risk-Adapted Therapy (mSMART) Guidelines

Prolonged follow‐up after initial therapy with 2‐chlorodeoxyadenosine in patients with indolent non‐Hodgkin lymphoma

Cladribine combined with cyclophosphamide and mitoxantrone as front-line therapy in chronic lymphocytic leukemia

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