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Four patients presented haematologic toxicity, grade 3 neutropenia, requiring G-CSF, treatment delay was only required in one of them.Other AE: grade 2 anaemia treated with erythropoietin (n=1), grade 2 thrombocytopenia (n=1), respiratory infections (n=2; one patient with hypogammaglobulinaemia previous to treatment required hospital admission and treatment suspension).By the time the study was finished, effectiveness was evaluated in four up to six patients that finished treatment: complete response (n=3) and partial response (n=1). Conclusion In our experience, the obinuzumab-chlorambucil scheme presented a good safety profile in patients with comorbidities. The main AE were IRRs: limited to first administration that did not require treatment suspension; and neutropaenia, which was the most frequent haematologic toxicity.Regarding response, a continuous monitoring is necessary to confirm long-term effectiveness.

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Conclusion and relevance Inhibition of the CDK4/6-Rb-E2F pathway by ribociclib showed preliminary limited clinical response in patients with AST and lymphomas. However, the observation of prolonged SD support further investigation of ribociclib in combination with other agents, especially mTOR/ PI3K inhibitors.