Format

Send to

Choose Destination
Acta Haematol. 2019 Jul 23:1-9. doi: 10.1159/000500164. [Epub ahead of print]

Pentostatin, Cyclophosphamide, and Rituximab Followed by Alemtuzumab for Relapsed or Refractory Chronic Lymphocytic Leukemia: A Phase 2 Trial of the ECOG-Acrin Cancer Research Group (E2903).

Author information

1
Beth Israel Comprehensive Cancer Center, New York, New York, USA, skmd3@aol.com.
2
Dana Farber Cancer Institute-ECOG-ACRIN Biostatistics Center, Boston, Massachusetts, USA.
3
Mayo Clinic, Rochester, Minnesota, USA.
4
Montefiore Medical Center, Bronx, New York, USA.
5
Marshfield Clinic, Marshfield, Wisconsin, USA.
6
Northwestern University, Chicago, Illinois, USA.
7
Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA.
8
University Hospitals of Cleveland, Cleveland, Ohio, USA.
9
Sparrow Herbert-Herman Cancer Center, Lansing, Michigan, USA.
10
University of Wisconsin Hospital and Clinics, Madison, Wisconsin, USA.
11
Sanford Medical Center, Fargo, North Dakota, USA.
12
Memorial Sloan Kettering Cancer Center, New York, New York, USA.

Abstract

Patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) may benefit from salvage chemoimmunotherapy (CIT). To explore further the use of CIT in the pre-novel agent era, ECOG-ACRIN undertook a phase 2 trial (E2903) for R/R CLL utilizing pentostatin, cyclophosphamide, and rituximab (PCR) followed by a consolidation course of alemtuzumab. This trial enrolled 102 patients with a median age of 64 years. Treatment consisted of 6 cycles of PCR followed by alemtuzumab for either 4 or 18 weeks depending on the initial response to PCR. The overall response after PCR (complete remission, CR, nodular partial remission, nPR, and partial remission, PR) was 55%. Major responses (CR or nPR) were achieved in 6%. The median overall survival (OS) and the median progression-free survival were 28 and 12 months, respectively. The most serious nonlethal adverse events were myelosuppression, febrile neutropenia, fatigue, nausea, and hyponatremia. PCR is an effective and well-tolerated nucleoside-based regimen for heavily pretreated CLL patients with R/R disease. The addition of alemtuzumab to CLL patients with a minor response (PR) or stable disease did not result in a significant number of higher responses (CR or nPR) nor an improvement in OS.

KEYWORDS:

Alemtuzumab; Chemoimmunotherapy; Chronic lymphocytic leukemia; Cyclophosphamide; Pentostatin; Refractory disease; Relapse; Rituximab

PMID:
31336367
DOI:
10.1159/000500164

Supplemental Content

Full text links

Icon for S. Karger AG, Basel, Switzerland
Loading ...
Support Center