Efficacy of high-dose corticosteroid-based treatment for chronic lymphocytic leukemia patients with p53 abnormalities in the era of B-cell receptor inhibitors.

Abstract

PURPOSE:

High-dose methylprednisolone (HDMP) with or without anti-CD20 antibody treatment in the pre B-cell receptor inhibitor (BCRi) era was used as potential salvage therapy for relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (r/r CLL/SLL) patients bearing the 17p deletion.

PATIENTS AND METHODS:

Outcomes were compared in retrospect between r/r patients treated with HDMP (n = 20), ibrutinib (n = 39) and idelalisib with rituximab (n = 14).

RESULTS:

Higher overall response rates were found in those patients undergoing BCRi therapy compared to HDMP (79.2% vs. 0%; p < 0.0001), along with longer median progression-free survival (not reached vs. 24.1 months; p < 0.01). Nevertheless, there were no differences in the overall survival (HDMP 35.87 months vs. not reached; p = 0.58).

CONCLUSION:

HDMP treatment was significantly inferior in terms of response rate and progression-free survival in r/r CLL/SLL patients with the 17p deletion, and may only be used whenever novel compounds are unavailable.

• Authors: Bartosz Puła, Monika Długosz-Danecka, Aleksander Salomon-Perzyński, Agnieszka Szymczyk, Edyta Subocz, Bożena Katarzyna Budziszewska, Justyna Rybka, Lidia Gil, Anna Waszczuk-Gajda, Elżbieta Iskierka-Jażdżewska, Jan M Zaucha, Michał Osowiecki, Weronika Piszczek, Paweł Steckiewicz, Łukasz Szukalski, Marek Hus, Ewa Lech-Marańda, Wojciech Jurczak, Krzysztof Jamroziak
• Journal: Advances in medical sciences (Adv Med Sci) Vol. 65 Issue 2 Pg. 371-377 (Sep 2020) ISSN: 1898-4002 [Electronic] Netherlands
• PMID: 32659728 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.

Chemical References

• Piperidines
• Purines
• Quinazolinones
• TP53 protein, human
• Tumor Suppressor Protein p53
• ibrutinib
• BCR protein, human
• Proto-Oncogene Proteins c-bcr
• Adenine
• Methylprednisolone
• idelalisib

Topics

• Adenine (administration & dosage, analogs & derivatives)
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Drug Resistance, Neoplasm
• Female
• Follow-Up Studies
• Humans
• Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy, metabolism, pathology)
• Male
• Methylprednisolone (administration & dosage)
• Middle Aged
• Neoplasm Recurrence, Local (drug therapy, metabolism, pathology)
• Piperidines (administration & dosage)
• Prognosis
• Proto-Oncogene Proteins c-bcr (antagonists & inhibitors)
• Purines (administration & dosage)
• Quinazolinones (administration & dosage)
• Retrospective Studies
• Salvage Therapy
• Survival Rate
• Tumor Suppressor Protein p53 (genetics, metabolism)