Enhancing the action of rituximab by adding fresh frozen plasma for the treatment of fludarabine refractory chronic lymphocytic leukemia
Enhancing the action of rituximab by adding fresh frozen plasma for the treatment of fludarabine refractory chronic lymphocytic leukemia
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DOI：
10.1002/ijc.25560
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发表时间：
2011-05
影响因子：
6.4
通讯作者：
Wei Xu;K. Miao;Dan-xia Zhu;Cheng Fang;Hua-yuan Zhu;Huajie Dong;Dong-mei Wang;Yu-jie Wu;C. Qiao;Jian-yong Li
中科院分区：
文献类型：
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作者：
Wei Xu;K. Miao;Dan-xia Zhu;Cheng Fang;Hua-yuan Zhu;Huajie Dong;Dong-mei Wang;Yu-jie Wu;C. Qiao;Jian-yong Li
在许多慢性淋巴细胞白血病（CLL）患者中已发现补体缺乏。提供新鲜冷冻血浆（FFP）来源的补体可增强利妥昔单抗对补体依赖性细胞的溶解作用。本研究的目的是评价在利妥昔单抗基础上加用FFP治疗氟达拉滨难治性CLL患者的临床疗效和安全性。22例患者接受2个单位的FFP治疗，随后接受利妥昔单抗375 mg/m2单药治疗，每1-2周重复一次。患者接受中位4个疗程的FFP和利妥昔单抗联合治疗（范围：2-6）。16例患者（72.7%）对治疗有反应，7例（31.8%）达到完全缓解。其中3例（13.6%）治疗后无微小残留病变。ZAP-70或CD 38高表达、免疫球蛋白重链可变区未突变、p53突变或不良细胞遗传学特征的患者，其治疗应答率与不具有这些特征的患者相似。中位随访时间为12（4-19）个月，尚未达到中位总生存期和无进展生存期。毒性很小，治疗耐受性良好。我们的数据表明，在利妥昔单抗基础上加用FFP是治疗氟达拉滨难治性CLL患者的有效非骨髓毒性方案。
Complement deficiencies have been identified in many chronic lymphocytic leukemia (CLL) patients. Supplying fresh frozen plasma (FFP)‐derived complement can enhance complement‐dependent cell lysis by the rituximab. The objective of our study was to evaluate the clinical efficacy and safety of the treatment by adding FFP to rituximab in fludarabine refractory CLL patients. Twenty‐two patients were treated with two units of FFP followed with rituximab, 375 mg/m2, as a single agent, repeated every 1–2 weeks. Patients received a median of four courses of the combined FFP and rituximab treatment (range: 2–6). Sixteen patients (72.7%) responded to treatment and seven (31.8%) achieved a complete remission. Three (13.6%) of which had no evidence of minimal residual disease after treatment. Patients with high expression of ZAP‐70 or CD38, unmutated immunoglobulin heavy chain variable region, mutated p53, or adverse cytogenetic features, achieved response to treatment at rates that appeared similar to those who did not have such characteristics. With a median follow‐up of 12 (4–19) months, the median overall survival and progression free survival have not been achieved. Toxicity was minimal, and the treatment was well tolerated. Our data suggest that the adding FFP to rituximab is an effective nonmyelotoxic regimen for the treatment of fludarabine refractory CLL patients.