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Cyclophosphamide, alvocidib (flavopiridol), and rituximab, a novel feasible chemoimmunotherapy regimen for patients with high-risk chronic lymphocytic leukemia.

Abstract
Alvocidib has demonstrated efficacy in high-risk chronic lymphocytic leukemia (CLL) patients. In this phase I study, we combined cyclophosphamide, alvocidib and rituximab (CAR) in a schema designed to mitigate tumor lysis syndrome (TLS) seen previously with alvocidib. Nine nucleoside analog-naïve, high-risk patients received escalating doses of CAR therapy. Dose limiting toxicity was not experienced. No instances of TLS were observed. Patient responses included three complete remissions and four partial remissions. CAR was tolerable and active in high-risk CLL patients without TLS toxicity. With continued monitoring of toxicities, a phase Ib/II study of this combination as frontline therapy is warranted.
AuthorsDeborah M Stephens, Amy S Ruppert, Kami Maddocks, Leslie Andritsos, Robert Baiocchi, Jeffrey Jones, Amy J Johnson, Lisa L Smith, Yuan Zhao, Yonghua Ling, Junan Li, Mitch A Phelps, Michael R Grever, John C Byrd, Joseph M Flynn
JournalLeukemia research (Leuk Res) Vol. 37 Issue 10 Pg. 1195-9 (Oct 2013) ISSN: 1873-5835 [Electronic] England
PMID23867058 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2013 Elsevier Ltd. All rights reserved.
Chemical References
  • Antibodies, Monoclonal, Murine-Derived
  • Flavonoids
  • Piperidines
  • alvocidib
  • Rituximab
  • Cyclophosphamide
Topics
  • Adult
  • Aged
  • Antibodies, Monoclonal, Murine-Derived (administration & dosage)
  • Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
  • Cyclophosphamide (administration & dosage)
  • Female
  • Flavonoids (administration & dosage)
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy, pathology)
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Piperidines (administration & dosage)
  • Rituximab
  • Treatment Outcome

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