Efficacy of rituximab in combination with steroids in refractory chronic lymphocytic leukemia

Quinn, John; Mohamedbhai, Sajir; Chipperfield, Kelly Maree; Treacy, M.; D’Sa, Shirley; Nathwani, Amit C.

doi:10.1080/10428190802340192

Cited by 14 publications

(11 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar results, summarized in Table 5, were observed in the Mayo Clinic retrospective study and in smaller series of heavily pretreated patients (ORR 93% to 75%, median PFS or duration of response 7 to 14 months) 117–119. In all series a high activity of the combination was reported in patients with aggressive disease features including those with del17p and/or bulky adenopathy, although in all studies a significantly high rate of infection (21.4% to 29%) was observed.…”

Section: Rituximab In Combination With Nonchemotherapeutic Agentssupporting

confidence: 85%

The spectrum of use of rituximab in chronic lymphocytic leukemia

Tedeschi

Vismara²,

Ricci³

et al. 2010

OTT

View full text Add to dashboard Cite

The monoclonal chimeric anti-CD20 antibody, rituximab, has considerably improved therapeutic outcome in B-cell chronic lymphocytic leukemia. Rituximab has limited clinical activity when used as a single agent. The combination of the monoclonal antibody with fludarabine-based regimens clearly demonstrated, in Phase II and randomized trials, an increase in clinical efficacy in previously untreated and pretreated patients. Furthermore the addition of rituximab enabled the eradication of minimal residual disease, which is correlated with the prognosis in a high proportion of patients. Although the combination of rituximab with fludarabine-based regimens increased myelosuppression and immunosuppression, incidence of infections did not increase. The benefit of adding rituximab to other purine analogs or other chemotherapeutic combination regimens has also been explored. Moreover there could be a role for achieving better quality of responses with the combination of different monoclonal antibodies, considering that they target different antigens and exert different mechanism of action. Although the role of rituximab as maintenance therapy in low grade non-Hodgkin’s lymphomas has been determined, the benefit and optimal schedule in chronic lymphocytic leukemia are still under investigation. This review brings together knowledge of the pharmacokinetics, mechanism of action and clinical use of rituximab in chronic lymphocytic leukemia.

show abstract

Section: Rituximab In Combination With Nonchemotherapeutic Agentssupporting

confidence: 85%

The spectrum of use of rituximab in chronic lymphocytic leukemia

Tedeschi

Vismara²,

Ricci³

et al. 2010

OTT

View full text Add to dashboard Cite

show abstract

“…Logical combinations of rituximab and HDMP (and a pilot study of alemtuzumab plus HDMP) were later published by several groups [9][10][11][12][13][14]. The overall response rate ranged from 62% [14] to 93% [10,11].…”

Section: Discussionmentioning

confidence: 97%

“…Life-threatening infections are the most serious side effects. Use of high-dose dexamethasone (40 mg on days 1-4 repeated every 28 days) with rituximab in six CLL patients (pts) has been recently reported in a small study with similar activity to R-HDMP [13]. Therefore, the aim of the present project was to retrospectively assess the efficacy and toxicity of rituximab-dexamethasone (R-dex) combination in pts with relapsed/refractory CLL.…”

Section: Introductionmentioning

confidence: 97%

Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia

Smolej¹,

Doubek²,

Panovská³

et al. 2012

Leukemia Research

View full text Add to dashboard Cite

“…The use of high‐dose corticosteroids in relapsed/refractory CLL was first reported by Thornton in 1999 with promising activity. Logical combinations of rituximab and HDMP were later published by several groups . The therapeutic efficacy ranged from 75 to 93% .…”

Section: Discussionmentioning

confidence: 99%

“…The target dose of dexamethasone (320 mg per cycle) is approximately six times lower than the dose of methylprednisolone in R‐HDMP regimens with regard to the relative glucocorticoid activity. This dose was selected based on our prior clinical experience with dexamethasone in combination with rituximab .…”

Section: Introductionmentioning

confidence: 99%

Ofatumumab added to dexamethasone in patients with relapsed or refractory chronic lymphocytic leukemia: Results from a phase II study

et al. 2015

View full text Add to dashboard Cite

The treatment of relapsed/refractory chronic lymphocytic leukemia (CLL) remains a challenging clinical issue. An important treatment option is the use of high-dose corticosteroids. The purpose of this clinical trial was to determine the efficacy and toxicity of an ofatumumab-dexamethasone (O-Dex) combination in relapsed or refractory CLL. The trial was an open-label, multicenter, nonrandomized, Phase II study. The O-Dex regimen consisted of intravenous ofatumumab (Cycle 1: 300 mg on day 1, 2,000 mg on days 8, 15, and 22; Cycles 2-6: 1,000 mg on days 1, 8, 15, and 22) and oral dexamethasone (40 mg on days 1-4 and 15-18; Cycles 1-6). The ODex regimen was given until best response, or a maximum of six cycles. Thirty-three patients (pts) were recruited. Twenty-four (73%) pts completed at least three cycles of therapy. The remaining nine pts were prematurely discontinued owing to Grade 3/4 infections (seven pts), disease progression (one pt), or uncontrollable diabetes mellitus (one pt). Overall response rates/complete remissions (ORR/CR) were achieved in 22/5 pts (67/15%). The median progression-free survival (PFS) was 10 months. In pts with p53 defects (n 5 8), ORR/CR were achieved in 5/2 pts (63/25%) with a median PFS of 10.5 months. The median overall survival (OS) was 34 months. The Grades 3-5 infectious toxicity in 33% of pts represented the most frequent side effect during the treatment period. In conclusion, the O-Dex regimen shows a relatively high ORR and CR with promising findings for PFS and OS.

show abstract

Efficacy of rituximab in combination with steroids in refractory chronic lymphocytic leukemia

Cited by 14 publications

References 11 publications

The spectrum of use of rituximab in chronic lymphocytic leukemia

The spectrum of use of rituximab in chronic lymphocytic leukemia

Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia

Ofatumumab added to dexamethasone in patients with relapsed or refractory chronic lymphocytic leukemia: Results from a phase II study

Contact Info

Product

Resources

About