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Cyclophosphamide, alvocidib (flavopiridol), and rituximab, a novel feasible chemoimmunotherapy regimen for patients with high-risk chronic lymphocytic leukemia.


ABSTRACT: Alvocidib has demonstrated efficacy in high-risk chronic lymphocytic leukemia (CLL) patients. In this phase I study, we combined cyclophosphamide, alvocidib and rituximab (CAR) in a schema designed to mitigate tumor lysis syndrome (TLS) seen previously with alvocidib. Nine nucleoside analog-naïve, high-risk patients received escalating doses of CAR therapy. Dose limiting toxicity was not experienced. No instances of TLS were observed. Patient responses included three complete remissions and four partial remissions. CAR was tolerable and active in high-risk CLL patients without TLS toxicity. With continued monitoring of toxicities, a phase Ib/II study of this combination as frontline therapy is warranted.

SUBMITTER: Stephens DM 

PROVIDER: S-EPMC3934299 | biostudies-literature | 2013 Oct

REPOSITORIES: biostudies-literature

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Cyclophosphamide, alvocidib (flavopiridol), and rituximab, a novel feasible chemoimmunotherapy regimen for patients with high-risk chronic lymphocytic leukemia.

Stephens Deborah M DM   Ruppert Amy S AS   Maddocks Kami K   Andritsos Leslie L   Baiocchi Robert R   Jones Jeffrey J   Johnson Amy J AJ   Smith Lisa L LL   Zhao Yuan Y   Ling Yonghua Y   Li Junan J   Phelps Mitch A MA   Grever Michael R MR   Byrd John C JC   Flynn Joseph M JM  

Leukemia research 20130715 10


Alvocidib has demonstrated efficacy in high-risk chronic lymphocytic leukemia (CLL) patients. In this phase I study, we combined cyclophosphamide, alvocidib and rituximab (CAR) in a schema designed to mitigate tumor lysis syndrome (TLS) seen previously with alvocidib. Nine nucleoside analog-naïve, high-risk patients received escalating doses of CAR therapy. Dose limiting toxicity was not experienced. No instances of TLS were observed. Patient responses included three complete remissions and four  ...[more]

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