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

J 2012

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

SMOLEJ, Lukáš, Michael DOUBEK, Anna PANOVSKÁ, Martin ŠIMKOVIČ, Yvona BRYCHTOVÁ et. al.

Základní údaje

Originální název

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

Autoři

SMOLEJ, Lukáš (203 Česká republika, garant), Michael DOUBEK (203 Česká republika, domácí), Anna PANOVSKÁ (203 Česká republika, domácí), Martin ŠIMKOVIČ (203 Česká republika), Yvona BRYCHTOVÁ (203 Česká republika, domácí), David BELADA (203 Česká republika), Monika MOTYČKOVÁ (203 Česká republika) a Jiří MAYER (203 Česká republika, domácí)

Vydání

Leukemia Research, Oxford, UK, PERGAMON-ELSEVIER SCIENCE LTD, 2012, 0145-2126

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30200 3.2 Clinical medicine

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.764

Kód RIV

RIV/00216224:14740/12:00065566

Organizační jednotka

Středoevropský technologický institut

DOI

http://dx.doi.org/10.1016/j.leukres.2012.07.005

UT WoS

000308044100013

Klíčová slova anglicky

Chronic lymphocytic leukemia Rituximab Dexamethasone Refractory disease Chemoimmunotherapy Corticosteroids

Štítky

ok, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 20. 3. 2014 13:36, Olga Křížová

Anotace

V originále

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.

Návaznosti

MSM0021622430, záměr

Název: Funkční a molekulární charakteristiky nádorových a normálních kmenových buněk - identifikace cílů pro nová terapeutika a terapeutické strategie

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Funkční a molekulární charakteristiky nádorových a normálních kmenových buněk - identifikace cílů pro nová terapeutika a terapeutické strategie

NT11218, projekt VaV

Název: Funkční a strukturní změny microRNA u lymfoproliferativních malignit a jejich vliv na prognózu onemocnění a predikci léčebné odpovědi

Přiložené soubory

LR4668.pdf

Požádat o autorskou verzi souboru

Citovat

SMOLEJ, Lukáš, Michael DOUBEK, Anna PANOVSKÁ, Martin ŠIMKOVIČ, Yvona BRYCHTOVÁ, David BELADA, Monika MOTYČKOVÁ a 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, roč. 36, č. 10, s. 1278-1282. ISSN 0145-2126. Dostupné z: https://dx.doi.org/10.1016/j.leukres.2012.07.005.

@article{989192,
   author = {Smolej, Lukáš and Doubek, Michael and Panovská, Anna and Šimkovič, Martin and Brychtová, Yvona and Belada, David and Motyčková, Monika and Mayer, Jiří},
   article_location = {Oxford, UK},
   article_number = {10},
   doi = {http://dx.doi.org/10.1016/j.leukres.2012.07.005},
   keywords = {Chronic lymphocytic leukemia Rituximab Dexamethasone Refractory disease Chemoimmunotherapy Corticosteroids},
   language = {eng},
   issn = {0145-2126},
   journal = {Leukemia Research},
   title = {Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia},
   url = {http://www.sciencedirect.com/science/article/pii/S0145212612002925#gs0025},
   volume = {36},
   year = {2012}
}

TY  - JOUR
ID  - 989192
AU  - Smolej, Lukáš - Doubek, Michael - Panovská, Anna - Šimkovič, Martin - Brychtová, Yvona - Belada, David - Motyčková, Monika - Mayer, Jiří
PY  - 2012
TI  - Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia
JF  - Leukemia Research
VL  - 36
IS  - 10
SP  - 1278-1282
EP  - 1278-1282
PB  - PERGAMON-ELSEVIER SCIENCE LTD
SN  - 01452126
KW  - Chronic lymphocytic leukemia Rituximab Dexamethasone Refractory disease Chemoimmunotherapy Corticosteroids
UR  - http://www.sciencedirect.com/science/article/pii/S0145212612002925#gs0025
L2  - http://www.sciencedirect.com/science/article/pii/S0145212612002925#gs0025
N2  - 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.
ER  -

SMOLEJ, Lukáš, Michael DOUBEK, Anna PANOVSKÁ, Martin ŠIMKOVIČ, Yvona BRYCHTOVÁ, David BELADA, Monika MOTYČKOVÁ a Jiří MAYER. Rituximab in combination with high-dose dexamethasone for the treatment of relapsed/refractory chronic lymphocytic leukemia. \textit{Leukemia Research}. Oxford, UK: PERGAMON-ELSEVIER SCIENCE LTD, 2012, roč.~36, č.~10, s.~1278-1282. ISSN~0145-2126. Dostupné z: https://dx.doi.org/10.1016/j.leukres.2012.07.005.

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