SMOLEJ, Lukáš, Michael DOUBEK, Anna PANOVSKÁ, Martin ŠIMKOVIČ, Yvona BRYCHTOVÁ, David BELADA, Monika MOTYČKOVÁ and Jiří MAYER. Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia. Leukemia Research. Oxford, UK: PERGAMON-ELSEVIER SCIENCE LTD, 2012, vol. 36, No 10, p. 1278-1282. ISSN 0145-2126. doi:10.1016/j.leukres.2012.07.005.
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Basic information
Original name Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia
Authors SMOLEJ, Lukáš (203 Czech Republic, guarantor), Michael DOUBEK (203 Czech Republic, belonging to the institution), Anna PANOVSKÁ (203 Czech Republic, belonging to the institution), Martin ŠIMKOVIČ (203 Czech Republic), Yvona BRYCHTOVÁ (203 Czech Republic, belonging to the institution), David BELADA (203 Czech Republic), Monika MOTYČKOVÁ (203 Czech Republic) and Jiří MAYER (203 Czech Republic, belonging to the institution).
Edition Leukemia Research, Oxford, UK, PERGAMON-ELSEVIER SCIENCE LTD, 2012, 0145-2126.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher United Kingdom of Great Britain and Northern Ireland
Confidentiality degree is not subject to a state or trade secret
WWW URL
Impact factor Impact factor: 2.764
RIV identification code RIV/00216224:14740/12:00065566
Organization unit Central European Institute of Technology
Doi http://dx.doi.org/10.1016/j.leukres.2012.07.005
UT WoS 000308044100013
Keywords in English Chronic lymphocytic leukemia Rituximab Dexamethasone Refractory disease Chemoimmunotherapy Corticosteroids
Tags ok, rivok
Tags International impact, Reviewed
Changed by Changed by: Olga Křížová, učo 56639. Changed: 20. 3. 2014 13:36.
Abstract
High-dose methylprednisolone is active in treatment of relapsed/refractory chronic lymphocytic leukemia (CLL) but infectious toxicity is serious. The aim of this project was to retrospectively assess efficacy and safety of high-dose dexamethasone combined with rituximab (R–dex) in this setting. Patients and methods: We treated 54 patients (pts) with relapsed/refractory CLL using R–dex regimen at two tertiary centers. Two schedules of rituximab were used (not randomized – based on the choice of the center): group 1, rituximab 500 mg/m2 day 1, 8, 15, 22 (375 mg/m2 in 1st dose) every 4 weeks (n = 29); group 2, 500 mg/m2 day 1 (375 mg/m2 in 1st cycle) repeated every 3 weeks (n = 25). The target dose of dexamethasone was 40 mg on days 1–4 and 10–13 or 15–18. Rai III/IV stages were present in 82%, unmutated IgVH genes in 82%, del 11q in 38% and del 17p in 19% pts; 46% had bulky lymph nodes; 82% were pretreated with fludarabine and 29% with alemtuzumab. Results: Overall response rate/complete remissions were 62/21% (Group 1) and 72/4% (Group 2). In three patients, R–dex was successfully used for debulking before nonmyeloablative allogeneic stem cell transplantation. R–dex was particularly effective in improvement of anemia and thrombocytopenia (p = 0.0055 and p = 0.0036); B-symptoms resolved after treatment in 11/17 pts. Hematological toxicity was mild. Serious infections occurred in 32% pts. At the median follow-up of 9 and 10 months, median progression-free survival was 6 months in Group 1 and 6.9 months in Group 2 (p = ns); median overall survival was 14.1 months in Group 1 vs. not reached in Group 2 (p = ns). Conclusions: R–dex appears to be an active and feasible treatment for relapsed/refractory CLL. Infectious toxicity remains an important issue. Further investigation of this regimen in larger studies appears fully warranted.
Links
MSM0021622430, plan (intention)Name: Funkční a molekulární charakteristiky nádorových a normálních kmenových buněk - identifikace cílů pro nová terapeutika a terapeutické strategie
Investor: Ministry of Education, Youth and Sports of the CR, Functional and molecular characteristics of cancer and normal stem cells - identification of targets for novel therapeutics and therapeutic strategies
NT11218, research and development projectName: Funkční a strukturní změny microRNA u lymfoproliferativních malignit a jejich vliv na prognózu onemocnění a predikci léčebné odpovědi
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