|Fludarabine with cytarabine followed by reduced-intensity conditioning and allogeneic hematopoietic stem cell transplantation in patients with poor-risk chronic lymphocytic leukemia.|
|PMID: 23014659 Owner: NLM Status: MEDLINE|
|Allogeneic stem cell transplantation (SCT) is a treatment option for patients with poor-risk chronic lymphocytic leukemia (CLL). Sequential use of chemotherapy and reduced-intensity conditioning has been proposed to improve the treatment outcomes. Fludarabine (30 mg/m(2)/day) and cytarabine (2 g/m(2)/day) for 4 days (combination of fludarabine with cytarabine; FAraC) were used for cytoreduction. After 3 days of rest, reduced intensity conditioning (RIC) was carried out consisting of 4 Gy total body irradiation, 10-20 mg/kg/day antithymocyte globulin for 3 days, and 40-60 mg/kg/day cyclophosphamide for 2 days. The median time of neutrophil engraftment was 16 days. The most frequent toxicities were grades III/IV infections in 12 of 15 cases and gastrointestinal toxicities in 8 of 15 cases. Remission (complete remission + partial remission) was achieved in 14 of 15 patients (93 %), minimal residual disease negativity according to flowcytometric analysis was observed in 10 patients. Nonrelapse mortality after 1 and 2 years was 7 and 13 %, respectively. After the median follow-up from SCT of 30 months, 80 % of patients were alive (12/15), three patients have died, and three relapses occurred. The FAraC-RIC protocol seems to be a promising approach to the treatment of poor-risk CLL with a high response rate of 93 % and favorable progression-free survival and overall survival of 70 and 85 % at 2 years after SCT, respectively. Other prospective clinical trials are needed to confirm the results of this novel therapeutic strategy.|
|Marta Krejci; Michael Doubek; Yvona Brychtova; Olga Stehlikova; Jana Chovancova; Boris Tichy; Hana Skuhrova Francova; Milan Navratil; Miroslav Tomiska; Ondrej Horky; Sarka Pospisilova; Jiri Mayer|
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|Type: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't Date: 2012-09-27|
|Title: Annals of hematology Volume: 92 ISSN: 1432-0584 ISO Abbreviation: Ann. Hematol. Publication Date: 2013 Jan|
|Created Date: 2013-01-11 Completed Date: 2013-03-07 Revised Date: 2013-05-27|
Medline Journal Info:
|Nlm Unique ID: 9107334 Medline TA: Ann Hematol Country: Germany|
|Languages: eng Pagination: 249-54 Citation Subset: IM|
|Department of Internal Medicine, Hematology and Oncology, University Hospital Brno and Masaryk University, Jihlavska 20, Brno, Czech Republic. email@example.com|
|APA/MLA Format Download EndNote Download BibTex|
Antibodies, Monoclonal, Humanized / therapeutic use
Antibodies, Monoclonal, Murine-Derived / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
Bone Marrow Transplantation / adverse effects
Cyclophosphamide / administration & dosage
Cytarabine / administration & dosage
Dexamethasone / administration & dosage
Drug Resistance, Neoplasm
Immunosuppressive Agents / therapeutic use
Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*, surgery
Peripheral Blood Stem Cell Transplantation* / adverse effects
Prednisolone / administration & dosage
Transplantation Conditioning / adverse effects, methods*
Vidarabine / administration & dosage, analogs & derivatives
Vincristine / administration & dosage
|0/Antibodies, Monoclonal, Humanized; 0/Antibodies, Monoclonal, Murine-Derived; 0/Immunosuppressive Agents; 0/rituximab; 147-94-4/Cytarabine; 3A189DH42V/alemtuzumab; 50-02-2/Dexamethasone; 50-18-0/Cyclophosphamide; 50-24-8/Prednisolone; 5536-17-4/Vidarabine; 57-22-7/Vincristine; P2K93U8740/fludarabine|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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