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Chronic Lymphocytic Leukemia

Rituximab in combination with high-dose methylprednisolone for the treatment of fludarabine refractory high-risk chronic lymphocytic leukemia

Leukemia volume 22, pages 2048–2053 (2008)Cite this article

Abstract

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/m2 weekly for 4 weeks) in combination with HDMP (1 gm/m2 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.

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Acknowledgements

We thank Robier Aguillon and Oliver Loria for assistance with data collection. This work was supported in part by National Institutes of Health Grant PO1-CA081534 (TJK) and from the National Institutes of Health Grant K08-CA106 605-01 (JEC).

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Authors and Affiliations

  1. Moores UCSD Cancer Center, La Jolla, CA, USA

    J E Castro, J D Sandoval-Sus, J Bole, L Rassenti & T J Kipps

  2. CLL Research Consortium, La Jolla, CA, USA

    J E Castro, J D Sandoval-Sus, J Bole, L Rassenti & T J Kipps

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  1. J E Castro
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  2. J D Sandoval-Sus
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Correspondence to T J Kipps.

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Castro, J., Sandoval-Sus, J., Bole, J. et al. Rituximab in combination with high-dose methylprednisolone for the treatment of fludarabine refractory high-risk chronic lymphocytic leukemia. Leukemia 22, 2048–2053 (2008). https://doi.org/10.1038/leu.2008.214

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