Comparative efficacy of chronic lymphocytic leukemia treatment with or without rituximab
https://doi.org/10.17650/1818-8346-2019-14-4-12-17
Abstract
Background. Monoclonal antibodies are modern drugs for the treatment of chronic lymphocytic leukemia.
The objective is a comparative study of the monoclonal antibody rituximab efficacy when added to cyclophosphamide + fludarabine (RFC versus FC regimen) in the treatment of chronic lymphocytic leukemia.
Materials and methods. A retrospective study was conducted in Clinical Medical Unit No. 1 of Perm. In total, the response to treatment was analyzed in 22patients (11 patients in each group (FC and RFC therapy)).
Results. Adding rituximab to the FC treatment regimen reduced the number of lymphocytes below 4 х 10 9/L after the 1st course, while maintaining the neutrophil level above 1.5 х 109/L, the absence of anemia (hemoglobin level >130 g/L) and thrombocytopenia (platelet count > 100 х 109/L). An additional assessment of creatinine and uric acid levels showed the absence of tumor lysis syndrome during RFC therapy.
Conclusion. The addition of rituximab (RFC therapy) to cyclophosphamide + fludarabine (FC therapy) provides a more rapid therapy response without adverse toxic effects such as impact on bone marrow functional activity and tumor lysis syndrome.
About the Authors
E. A. Zenkova
Perm State Medical University named after Academician E.A. Wagner, Ministry of Health of Russia
Russian Federation
Russian Federation
26 Petropavlovskaya St., Perm 614000
Б. Е. Kugushev
Perm State Medical University named after Academician E.A. Wagner, Ministry of Health of Russia
Russian Federation
Russian Federation
26 Petropavlovskaya St., Perm 614000
E. R. Vasilieva
Clinical Medical Unit No. 1 of Perm
Russian Federation
Russian Federation
68 Gagarina Bul'var, Perm 614 077
References
1. Prica A., Baldassarre F., Hicks L.K. et al. Rituximab in lymphoma and chronic lymphocytic leukaemia: a practice guideline. Clin Oncol 2017;29(1):13—28. DOI: 10.1016/j.clon.2016.09.004.
2. Keating G.M. Rituximab: a review of its use in chronic lymphocytic leukaemia, low-grade or follicular lymphoma and diffuse large B-cell lymphoma. Drugs 2010;70(11):1445—76. DOI: 10.2165/11201110-000000000-00000.
3. Plosker G.L., Figgitt D.P. Rituximab: a review of its use in non-Hodgkin’s lymphoma and chronic lymphocytic leukaemia. Drugs 2003;63(8):803—43. DOI: 10.2165/00003495-200363080-00005.
4. Simon R., Paul S., Peter W.M. et al. The addition of rituximab to fludarabine and cyclophosphamide chemotherapy results in a significant improvement in overall survival in patients with newly diagnosed mantle cell lymphoma: results of a randomized UK. National Cancer Research Institute trial. Haematologica 2016;101(2):235—40. DOI: 10.3324/haematol.2015.128710.
5. Clinical recommendations for the diagnosis and treatment of lymphoproliferative diseases. M., 2014. Pp. 132-146. (In Russ).
6. Cairo M.S, Bishop M. Tumour lysis syndrome: new therapeutic strategies and classification. Br J Haematol 2004;127(1):3—11. DOI: 10.1111/j.1365-2141.2004.05094.x.
7. Cortes J., Moore J.O., Maziarz R.T. et al. Control of plasma uric acid in adults at risk for tumor lysis syndrome: efficacy and safety of rasburicase alone and rasburicase followed by allopurinol compared with allopurinol alone — results of a multicenter phase III study. J Clin Oncol 2010;28(27):4207—13. DOI: 10.1200/JCO.2009.26.8896.
8. Parilova N.K., Sergeeva N.S., Marshutina N.V. et al. The prognostic value of thymidine kinase-1 in comparison with p2-microglobulin and lactate dehydrogenase in malignant lymphoproliferative diseases. Klinicheskaya onkogematologiya = Clinical Oncohematology 2016;9(1):6-12. (In Russ.).
9. Michael H., Cheson B.D., Catovsky D. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood 2018;131:2745-60. DOI: 10.1182/blood-2017-09-806398.
10. Bien E., Balcerska A. Serum soluble interleukin-2 receptor, beta2-microglobulin, lactate dehydrogenase and erythrocyte sedimentation rate in children with Hodgkin’s lymphoma. Scand J Immunol 2009;70(5):490—500. DOI: 10.1111/j.1365-3083.2009.02313.x.
Review
For citations:
Zenkova E.A., Kugushev Б.Е., Vasilieva E.R. Comparative efficacy of chronic lymphocytic leukemia treatment with or without rituximab. Oncohematology. 2019;14(4):12-17. (In Russ.) https://doi.org/10.17650/1818-8346-2019-14-4-12-17
Views:
9866
Email this article 