Rituximab in combination with high-dose methylprednisolone for the treatment of chronic lymphocytic leukemia.
Rituximab in combination with high-dose methylprednisolone for the treatment of chronic lymphocytic leukemia.
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我们观察到，大剂量甲基强的松龙（HSP 70）和利妥昔单抗（R）联合治疗氟达拉滨难治性慢性淋巴细胞白血病（CLL）患者耐受性良好，并具有良好的活性。这促使我们评估这些药物在一线治疗中的使用。28例患者入组本研究，中位年龄为65岁。患者在三个四周周期中的每个周期中接受每天1 g/m2的Hastin，持续三天，同时接受利妥昔单抗和预防性抗微生物治疗。治疗耐受性良好，很少有III级或更高级别的不良事件。总有效率为96%（N=27）。9例患者（32%）达到完全缓解（CR），其中2例未检出微小残留病（MRD）。6例MRD患者接受了Alemtuzumab巩固治疗;其中5例患者达到了MRD阴性CR。随访3年以上，中位无进展生存期为30.3个月，仅39%的患者需要额外治疗，总生存率为96%。这项研究表明，HALLY和利妥昔单抗是一种有效的非骨髓抑制治疗组合，用于CLL患者，值得考虑，特别是对于可能无法耐受标准治疗方案的骨髓储备有限的患者。
We observed that high-dose methylprednisolone (HDMP) and rituximab (R) was well tolerated and had promising activity when used in combination to treat patients with fludarabine-refractory chronic lymphocytic leukemia (CLL). This prompted us to evaluate the use of these agents in frontline therapy. Twenty-eight patients with a median age of 65 enrolled in this study. Patients received HDMP at 1 g/m2 each day for three days during each of the three four-week cycles together with rituximab and prophylactic anti-microbial therapy. The treatment was well tolerated with few adverse events of grade III or higher. The overall response rate was 96% (N=27). Nine patients (32%) achieved a complete remission (CR), two of which were without detectable minimal residual disease (MRD). Six patients with MRD received consolidation with alemtuzumab; five of these patients achieved an MRD-negative CR. With over three years of follow-up median progression free survival was 30.3 months with only 39% of patients requiring additional therapy, and an overall survival was 96%. This study demonstrates that HDMP and rituximab is an effective non-myelosuppressive treatment combination for patients with CLL that warrants consideration particularly for patients with limited myeloid reserve that might not tolerate standard treatment regimens.
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影响因子：
45.3
作者：
Byrd, JC;Murphy, T;Flinn, IW
通讯作者：
Flinn, IW
影响因子：
45.3
作者：
O'Brien, SM;Kantarjian, H;Keating, MJ
通讯作者：
Keating, MJ
影响因子：
45.3
作者：
Hillmen, Peter;Skotnicki, Aleksander B.;Mayer, Jiri
通讯作者：
Mayer, Jiri
影响因子：
5.8
作者：
Demko, Suzanne;Summers, Jeffrey;Pazdur, Richard
通讯作者：
Pazdur, Richard
影响因子：
45.3
作者：
Caligaris-Cappio, Federico;Ghia, Paolo
通讯作者：
Ghia, Paolo