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Blood, 15 January 2007, Vol. 109, No. 2, pp. 405-411. Prepublished online as a Blood First Edition Paper on September 28, 2006; DOI 10.1182/blood-2006-07-033274. This Article Full Text (PDF) All Versions of this Article: blood-2006-07-033274v1 109/2/405    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Kay, N. E. Articles by Byrd, J. C. Search for Related Content PubMed PubMed Citation Articles by Kay, N. E. Articles by Byrd, J. C. Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted July 12, 2006 Accepted August 22, 2006 Combination chemoimmunotherapy with pentostatin, cyclophosphamide and rituximab shows significant clinical activity with low accompanying toxicity in previously untreated B-chronic lymphocytic leukemia Neil E. Kay*, Susan M Geyer, Timothy G. Call, Tait D. Shanafelt, Clive S Zent, Diane F. Jelinek, Renee Tschumper, Nancy D Bone, Gordon W Dewald, Thomas S Lin, Nyla A Heerema, Lisa Smith, Michael R Grever, and John C. Byrd Mayo Clinic, Rochester, MN Ohio State University, Columbus, OH * Corresponding author; email: kay.neil{at}mayo.edu. Building on the prior work of pentostatin in chronic lymphocytic leukemia (CLL), we initiated a trial of combined pentostatin (2 mg/m2), cyclophosphamide (600 mg/m2) and rituximab (375 mg/m2) for symptomatic, previously untreated patients (n=65). Of 64 evaluable patients, 34 (53%) were high Rai risk, 71% were nonmutated for the immunoglobulin heavy chain variable region gene, 34% were CD38+ and 34% were ZAP-70+. Thirty patients (52%) had one FISH anomaly, and 21 (36%) had complex FISH defects. 38 patients (58%) had grade 3+ hematologic toxicity but minimal transfusion needs, and no major infections. Responses occurred in 58 (91%) with 26 (41%) complete responses (CR), 14 (22%) nodular partial responses (nodular PR), and 18 (28%) partial responses (PR)patients. Many patients with CR also lacked evidence of minimal residual disease by 2-color flow cytometry. Examination of prognostic factors demonstrated poor response in the 3 patients with del (17p). In contrast, we found this regimen was equally effective in young vs. elderly (>70 yrs) patients and in del(11)(q22.3) vs. other favorable prognostic factors. Thus, this novel regimen of pentostatin, cyclophosphamide and rituximab for previously untreated CLL demonstrated significant clinical activity despite poor risk-based prognoses, achievement of minimal residual disease in some, and modest toxicity. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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