Use of alemtuzumab and rituximab consolidation in CLL: Pros and cons.

被引:2
作者
Elter T. [1 ]
Eichhorst B.F. [1 ]
Wendtner C.M. [1 ]
机构
[1] Department I of Internal Medicine, University of Cologne, Kerpener Strasse 62, Cologne
关键词
Chronic Lymphocytic Leukemia; Induction Therapy; Minimal Residual Disease; Alemtuzumab; Chronic Lymphocytic Leukemia Patient;
D O I
10.1007/s11899-009-0006-5
中图分类号
学科分类号
摘要
As new therapeutic approaches have improved responses and outcomes in the treatment of chronic lymphocytic leukemia (CLL), the scientific community focuses now on diagnostic procedures and definitions of response in CLL. The use of monoclonal antibodies in particular has made it possible to treat CLL more effectively. The success of these new therapeutic tools can be traced back to the eradication of detectable disease in a significant number of patients. Therefore, the evaluation of minimal residual disease has become an important end point within clinical trials. This article describes various methods of assessing minimal residual disease and presents data demonstrating that new therapeutic approaches can eliminate residual malignant cells at the highest levels of sensitivity currently available. Although initial evidence suggests that the use of alemtuzumab induces a survival benefit when used in the consolidation setting, important safety issues remain to be resolved before this approach can be introduced in routine practice.
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页码:43 / 46
页数:3
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共 54 条
[1]  
Brugiatelli M.(1997)Long-term clinical outcome of B-cell chronic lymphocytic leukaemia patients in clinical remission phase evaluated at phenotypic level Br J Haematol 97 113-118
[2]  
Claisse J.F.(2000)Fludarabine compared with chlorambucil as primary therapy for chronic lymphocytic leukemia N Engl J Med 343 1750-1757
[3]  
Lenormand B.(1996)Multicentre prospective randomised trial of fludarabine versus cyclophosphamide, doxorubicin, and prednisone (CAP) for treatment of advanced-stage chronic lymphocytic leukaemia. The French Cooperative Group on CLL Lancet 347 1432-1438
[4]  
Rai K.R.(2001)Randomized comparison of fludarabine, CAP, and ChOP in 938 previously untreated stage B and C chronic lymphocytic leukemia patients Blood 98 2319-2325
[5]  
Peterson B.L.(1998)First line fludarabine treatment of symptomatic chronic lymphoproliferative diseases: clinical results and molecular analysis of minimal residual disease Eur J Haematol 61 197-203
[6]  
Appelbaum F.R.(1992)Response assessment in chronic lymphocytic leukemia after fludarabine plus prednisone: clinical, pathologic, immunophenotypic, and molecular analysis Blood 80 29-36
[7]  
Johnson S.(1999)Detection of minimal residual disease in B chronic lymphocytic leukemia (CLL) Hematol Cell Ther 41 13-18
[8]  
Smith A.G.(1996)Eradication of polymerase chain reaction-detectable chronic lymphocytic leukemia cells is associated with improved outcome after bone marrow transplantation Blood 88 2228-2235
[9]  
Loffler H.(1992)Evaluation of residual disease in B-cell chronic lymphocytic leukemia patients in clinical and bone-marrow remission using CD5–CD19 markers and PCR study of gene rearrangements Leuk Lymphoma 7 195-204
[10]  
Leporrier M.(2001)Quantitation of minimal disease levels in chronic lymphocytic leukemia using a sensitive flow cytometric assay improves the prediction of outcome and can be used to optimize therapy Blood 98 29-35