Fractionated cyclophosphamide, vincristine, liposomal daunorubicin, and dexamethasone plus rituximab and granulocyte‐macrophage–colony stimulating factor (GM‐CSF) alternating with methotrexate and cytarabine plus rituximab and GM‐CSF in patients with Richter syndrome or fludarabine‐refractory chronic lymphocytic leukemia

Tsimberidou, Apostolia M.; Kantarjian, Hagop M.; Cortes, Jorge; Thomas, Deborah A.; Faderl, Stefan; Garcia‐Manero, Guillermo; Verstovšek, Srđan; Ferrajoli, Alessandra; Wierda, William G.; Alvarado, Yesid; O’Brien, Susan; Albitar, Mäher; Keating, Michael J.; Giles, Francis J.

doi:10.1002/cncr.11238

Cited by 113 publications

(84 citation statements)

References 53 publications

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“…90 Y ibritumomab tiuxetan was inferior to other cytotoxic regiments used in RS. [1][2][3][4][5] In the 1970s and 1980s, these regimens included, but were not limited to, cyclophosphamide, doxorubicin, vincristine, prednisone, and bleomycin (CHOP-Bleo); methotrexate, doxorubicin, cyclophosphamide, vincristine, prednisone, and bleomycin (MACOP-B); doxorubicin, methylprednisolone, high-dose ara-C, and cisplatin (ASHAP); cisplatin, fludarabine, and cytarabine (PFA); and vincristine, doxorubucin, and dexamethasone (VAD) with or without radiotherapy. 1 In recent years, variants of the Hyper-CVAD regimen alternating with methotrexate and ara-C also have been used, but without significant improvement in the response rates or survival reported.…”

Section: Discussionmentioning

confidence: 99%

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Yttrium‐90 ibritumomab tiuxetan radioimmunotherapy in Richter syndrome

Tsimberidou

Murray

O’Brien

et al. 2004

Cancer

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BACKGROUND90Y ibritumomab tiuxetan is a radioimmunotherapeutic construct that is reported to be an effective treatment for patients with lymphoma. The aim of the current analysis was to evaluate retrospectively the efficacy and safety of 90Y ibritumomab tiuxetan in patients with Richter syndrome (RS).METHODSPatients with histologically proven CD20‐positive RS and < 25% lymphoma and/or chronic lymphocytic leukemia in the bone marrow were treated. Patients received an imaging dose of 111In‐labeled ibritumomab tiuxetan of 1.6 mg (5.0 mCi of 111In) intravenously. One week later, they received 0.3 or 0.4 mCi/kg of 90Y ibritumomab tiuxetan. Rituximab, at a dose of 250 mg/m2 intravenously, was given immediately before ibritumomab tiuxetan on Days 1 and 8.RESULTSSeven patients were treated. Their median age was 56 years (range, 44–70 years). The median time to transformation was 7.9 years (range, 0.7–28.4 years). The median number of previous therapies received was five (range, one to seven previous therapies). The median number of previous therapies received for RS was one (range, none to three previous therapies). Six patients were treated previously with hyperfractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone alternating with methotrexate and cytosine arabinoside. No patient responded to 90Y ibritumomab tiuxetan therapy. All patients developed disease progression. The median time to disease progression was 41 days (range, 39–89 days). Side effects included hematologic toxicity. Grade 3–4 (according to the second version of the National Cancer Institute Common Toxicity Criteria) thrombocytopenia and neutropenia occurred in 5 patients (71%) and 2 patients (29%), respectively. There was one episode of septic shock in a patient with Grade 4 neutropenia.CONCLUSIONS90Y ibritumomab tiuxetan had no significant antitumor activity and hematologic toxicity was severe in these heavily pretreated patients with RS. Cancer 2004. © 2004 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

“…Six patients were treated previously with Hyper-CVAD alternating with methotrexate and cytosine arabinoside (ara-C), with or without rituximab, and granulocyte-macrophage-colonystimulating factor (GM-CSF); and four of six patients had shown a response (one CR and three PRs). 3 One patient had received no previous therapy for RS.…”

Section: Patient Characteristicsmentioning

confidence: 99%

Yttrium‐90 ibritumomab tiuxetan radioimmunotherapy in Richter syndrome

Tsimberidou

Murray

O’Brien

et al. 2004

Cancer

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“…When treated with conventional chemotherapy alone, the median survival of these patients was less than 8 months. 71 In a small series of nine patients who received an allogeneic transplantation, three remained alive and in remission at 14, 47 and 67 months, respectively. 72 Two of the three patients in remission received an NMA preparative regimen.…”

Section: Therapy For Richter Syndromementioning

confidence: 98%

Stem cell transplantation for chronic lymphocytic leukemia: should not more patients get a transplant?

Jabbour

Keating

Champlin³

et al. 2004

Bone Marrow Transplant

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Summary:Novel therapeutic approaches with conventional chemotherapy and monoclonal antibody combinations have improved the complete remission rates in chronic lymphocytic leukemia. However, cure remains elusive, particularly in fludarabine-refractory patients, whose prognosis remains poor. Autologous stem cell transplantation (SCT) has been explored for such patients, lengthening the time to treatment failure in selected patients, but there is little hope that it will improve the cure rate. The strategy is particularly ineffective in patients with poor biological prognostic factors, such as abnormal cytogenetics and unmutated immunoglobulin heavy-chain variable region. Allogeneic SCT remains the only curative approach, producing an extended disease-free survival in 25-60%, mainly via the graft-versus-leukemia effect. The treatment-related mortality with such an approach has been significant, however, with a 30-40% risk of death within 100 days of the transplant. Nonmyeloablative (NMA) conditioning regimens may produce high response rates and lower morbidity, especially for patients with chemosensitive disease. Randomized trials designed according to the new biologic prognostic parameters described in chronic lymphocytic leukemia are required to better define the role of NMA SCT in the near future.

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“…Most data for treatment for RS is derived from single-arm phase I-II studies, and retrospective analyses [13,[72][73][74][75][76][77][78][79]. The standard therapy for RS is chemoimmunotherapy with a median survival after therapy of less than 1 year [36].…”

Section: Treatmentmentioning

confidence: 99%

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

et al. 2016

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Although generally considered a clinically indolent neoplasm, CLL/SLL may undergo transformation to a clinically aggressive lymphoma. The most common form of transformation, to DLBCL, is also known as Richter syndrome. Transformation determines the course of the disease and is associated with unfavorable patient outcome. Precise detection of transformation and identification of predictive biomarkers and specific molecular pathways implicated in the pathobiology of transformation in CLL/SLL will enable personalized therapeutic approach and provide potential avenues for improving the clinical outcome of patients. In this review, we present an overview of the pathologic features, risk factors, and pathogenic mechanisms of CLL/ SLL transformation.

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Abstract: Das fehlende Teil: Die lange gesuchte asymmetrische katalytische Dichlorierungsreaktion wurde kürzlich beschrieben (siehe Schema). Um zum Ziel zu gelangen, galt es in der Methodenentwicklung eine Reihe von Hindernissen zu überwinden.

Cited by 113 publications

References 53 publications

Yttrium‐90 ibritumomab tiuxetan radioimmunotherapy in Richter syndrome

Yttrium‐90 ibritumomab tiuxetan radioimmunotherapy in Richter syndrome

Stem cell transplantation for chronic lymphocytic leukemia: should not more patients get a transplant?

Histologic transformation of chronic lymphocytic leukemia/small lymphocytic lymphoma

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