Phase II trial of fludarabine phosphate in lymphoma: an effective new agent in low-grade lymphoma.

Redman, John R.; Cabanillas, Fernando; Velasquez, William S.; McLaughlin, Peter; Hagemeister, Fredrick B.; Swan, F.; Rodriguez, Maria Alma; Plunkett, William; Keating, Michael J.

doi:10.1200/jco.1992.10.5.790

Cited by 188 publications

(55 citation statements)

References 10 publications

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“…Fludarabine as a single agent was shown to have remarkable activity in a range of indolent lymphoid malignancies refractory to other treatments, including up to a 100% complete remission rate in relapsed CLL [27]. Fludarabine was shown to be superior to chlorambucil in a major intergroup study, with a higher response rate and longer disease-free interval [28].…”

Section: Purine Nucleoside Analoguesmentioning

confidence: 99%

Chronic Lymphocytic Leukemia: Recent Advances in Diagnosis and Treatment

Abbott

2006

The Oncologist

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Section: Purine Nucleoside Analoguesmentioning

confidence: 99%

Chronic Lymphocytic Leukemia: Recent Advances in Diagnosis and Treatment

Abbott

2006

The Oncologist

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“…[28][29][30] Fludara has been shown to be therapeutically efficacious against lymphoid malignancies. [31][32][33][34][35][36][37] In addition, it is an effective immunosuppressive drug 38,39 especially in conjunction with anti-T lymphocyte globulin (ATG), 39,40 and may possibly play a role in reducing the incidence and severity of graft-versus-host disease (GVHD). 41 We have recently demonstrated that it may be possible to achieve durable engraftment of donor hematopoietic stem cells while minimizing procedure-related toxicity using a low intensity conditioning regimen consisting of Fludara, busulfan (BU) and ATG prior to transplantation of granulocyte colony-stimulating factor (G-CSF)-mobilized allogeneic peripheral blood stem cells (alloSCT).…”

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confidence: 99%

Allogeneic peripheral blood stem cell transplantation using a fludarabine-based low intensity conditioning regimen for malignant lymphoma

Nagler¹,

Slavin²,

Váradi³

et al. 2000

Bone Marrow Transplant

171

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Summary:Relapse is a serious complication following high-dose therapy and autologous bone marrow transplantation (ABMT) for malignant lymphoma (ML). Allogeneic transplantation (alloSCT) is a therapeutic option. However, it is associated with a high incidence of transplantrelated organ toxicity and mortality. We recently reported fast engraftment and minimal transplantrelated toxicity, using fludarabine-based conditioning with reduced amounts of chemotoxic drugs prior to alloSCT. We now present our experience with 23 heavily treated high risk ML patients who underwent matched alloSCT following the same low intensity conditioning. The patients (20 male, three female) were aged 13-63 years. Nineteen had NHL and four HD (resistant disease 12, partial remission 11). Five were post ABMT. Twenty-two patients had fully matched sibling donors, and one a fully matched unrelated donor. Engraftment was fast. There was no rejection or nonengraftment. Organ toxicity was moderate with no liver or renal toxicity Ͼgrade II. Four patients developed Ͼgrade II graft-versus-host disease (GVHD). Seven patients died -four of grade III-IV GVHD and severe infections, two of bacterial sepsis, one of pulmonary failure. Ten patients are alive after 22.5 (15-37) months. Survival and disease-free survival at 37 months are both 40%. Probability of relapse is 26%. These encouraging results suggest that alloSCT following fludarabinebased low intensity conditioning in high-risk patients merits further evaluation. Bone Marrow Transplantation (2000) 25, 1021-1028. Keywords: allogeneic; peripheral blood stem cell transplantation; malignant lymphoma; fludarabine; low intensity conditioning regimen High-dose chemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT) has gained widespread acceptance as the treatment for aggressive nonHodgkin's lymphoma (NHL) in chemosensitive relapse,

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“…The majority of these infections have been Pneumocystis carinii pneumonia (PCP), 11 although CMV disease has been reported in this context. 12,13 A synergistic effect of steroids and fludarabine in predisposing to opportunistic infections is suggested by the observation of an increased incidence of listeriosis in non-transplant patients receiving both drugs. 14 A significant incidence of herpes zoster and PCP, in the absence of prophylaxis with aciclovir or trimethoprim-sulfamethaxole, has been reported with a fludarabine, mitoxantrone and dexamethasone combination.…”

Section: Discussionmentioning

confidence: 99%

Fatal CMV pneumonia associated with steroid therapy after autologous transplantation in patients previously treated with fludarabine

Grigg

Chapman

Szer

1998

Bone Marrow Transplant

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Summary:Fludarabine has been associated with an increased risk of opportunistic infections, possibly related to the induction of profound CD4 ϩ lymphopenia. We observed two cases of cytomegalovirus pneumonia (CMV-IP) in a total of nine patients over a 5-year period who had previously received fludarabine and who proceeded to autografting. Both patients also received steroids posttransplant. CMV-IP was observed in one of 104 other autograft recipients over this time who had not received prior fludarabine. This observation suggests that the combination of fludarabine pre-transplant and steroids post-transplant may increase the risk of invasive CMV disease in autograft recipients.

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Phase II trial of fludarabine phosphate in lymphoma: an effective new agent in low-grade lymphoma.

Cited by 188 publications

References 10 publications

Chronic Lymphocytic Leukemia: Recent Advances in Diagnosis and Treatment

Chronic Lymphocytic Leukemia: Recent Advances in Diagnosis and Treatment

Allogeneic peripheral blood stem cell transplantation using a fludarabine-based low intensity conditioning regimen for malignant lymphoma

Fatal CMV pneumonia associated with steroid therapy after autologous transplantation in patients previously treated with fludarabine

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