Risk factors for tumor lysis syndrome in patients with chronic lymphocytic leukemia treated with the cyclin-dependent kinase inhibitor, flavopiridol

被引：38

作者：

Blum, K. A. ^{[1
]}

Ruppert, A. S. ^{[1
]}

Woyach, J. A. ^{[1
]}

Jones, J. A. ^{[1
]}

Andritsos, L. ^{[1
]}

Flynn, J. M. ^{[1
]}

Rovin, B. ^{[2
]}

Villalona-Calero, M. ^{[3
]}

Ji, J. ^{[4
]}

Phelps, M. ^{[4
]}

Johnson, A. J. ^{[1
]}

Grever, M. R. ^{[1
]}

Byrd, J. C. ^{[1
,4
]}

机构：

[1] Ohio State Univ, Div Hematol, Dept Internal Med, Arthur G James Comprehens Canc Ctr, Columbus, OH 43210 USA

[2] Ohio State Univ, Div Nephrol, Dept Internal Med, Columbus, OH 43210 USA

[3] Arthur G James Comprehens Canc Ctr, Div Med Oncol, Dept Internal Med, Columbus, OH USA

[4] Ohio State Univ, Div Med Chem & Pharmacol, Coll Pharm, Columbus, OH 43210 USA

来源：

LEUKEMIA | 2011年 / 25卷 / 09期

关键词：

chronic lymphocytic leukemia; flavopiridol; tumor lysis syndrome; CONTINUOUS-INFUSION; FLUDARABINE; THERAPY; CYCLOPHOSPHAMIDE; GUIDELINES; MANAGEMENT; CONSENSUS; SCHEDULE; CANCER; CELLS;

D O I：

10.1038/leu.2011.109

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Tumor lysis syndrome (TLS) has been described in over 40% of patients with chronic lymphocytic leukemia treated with the cyclin-dependent kinase inhibitor, flavopiridol. We conducted a retrospective analysis to determine predictive factors for TLS. In 116 patients, the incidence of TLS was 46% (95% CI: 36-55%). In univariable analysis, female gender, greater number of prior therapies, Rai stages III-IV, adenopathy >= 10 cm, splenomegaly, del(11q), decreased albumin and increased absolute lymphocyte count, white blood cell count (WBC), beta 2-microglobulin, and lactate dehydrogenase were associated (P<0.05) with TLS. In multivariable analysis, female gender, adenopathy >= 10 cm, elevated WBC, increased beta 2-microglobulin, and decreased albumin were associated with TLS (P<0.05). With respect to patient outcomes, 49 and 44% of patients with and without TLS, respectively, responded to flavopiridol (P=0.71). In a multivariable analysis, controlling for number of prior therapies, cytogenetics, Rai stage, age and gender, progression-free survival (PFS) was inferior in patients with TLS (P=0.01). Female patients and patients with elevated b2-microglobulin, increased WBC, adenopathy >= 10cm and decreased albumin were at highest risk and should be monitored for TLS with flavopiridol. TLS does not appear to be predictive of response or improved PFS in patients receiving flavopiridol. Leukemia (2011) 25, 1444-1451; doi: 10.1038/leu.2011.109; published online 24 May 2011

引用

页码：1444 / 1451

页数：8

共 20 条

[1] Treatment of relapsed chronic lymphocytic leukemia by 72-hour continuous infusion or 1-hour bolus infusion of flavopiridol: Results from cancer and leukemia group B study 19805 [J].