Yazarlar : Badoux XC, Keating MJ, Wang X, O'Brien SM, Ferrajoli A, Faderl S, Burger J, Koller C, Lerner S, Kantarjian H, Wierda WG.

Yayın : Blood

Yayın Yılı : 2011

Pubmed Linki : http://www.ncbi.nlm.nih.gov/pubmed/21670470

Konu : Lösemi

Literatür İçeriği :  

Abstract

Patients with relapsed chronic lymphocytic leukemia (CLL) and high-risk features such as fludarabine refractoriness, complex karyotype or abnormalities of chromosome 17p experience poor outcomes after standard fludaradine-based regimens. Alemtuzumab is a chimeric CD52 monoclonal antibody with activity in CLL patients with fludarabine-refractory disease and 17p deletion. We report the outcome for 80 relapsed or refractory patients with CLL enrolled in a phase II study of cyclophosphamide, fludarabine, alemtuzumab and rituximab (CFAR). All patients were assessed for response and progression according to 1996 CLL-working group criteria. For the intention to treat analysis, the overall response rate (ORR) was 65%, including 29% CR. The estimated progression-free survival was 10.6 months and median overall survival was 16.7 months. Although we noted higher CR in high-risk patients following CFAR compared to a similar population who had received FCR as salvage therapy, there was no significant improvement in PFS and OS appeared worse. CFAR was associated with a high rate of infectious complications with 37 patients (46%) experiencing a serious infection during therapy and 28% of evaluable patients experiencing late serious infections. Although CFAR produced good response rates in this highly pre-treated high-risk group of patients there was no benefit in survival outcomes.

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