Risk-adapted, ofatumumab-based chemoimmunotherapy and consolidation in treatment-naive chronic lymphocytic leukemia: a phase 2 study.
Citation: Leukemia & Lymphoma. 62(8):1816-1827, 2021 08.PMID: 33653216Institution: Washington Cancer InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Leukemia, Lymphocytic, Chronic, B-Cell | Antibodies, Monoclonal, Humanized/tu [Therapeutic Use] | Antineoplastic Combined Chemotherapy Protocols/ae [Adverse Effects] | Humans | Immunotherapy | Leukemia, Lymphocytic, Chronic, B-Cell/di [Diagnosis] | Leukemia, Lymphocytic, Chronic, B-Cell/dt [Drug Therapy] | Treatment OutcomeYear: 2021ISSN:- 1026-8022
- Desai, Sanjal:
- https://orcid.org/0000-0002-7892-2625
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 33653216 | Available | 33653216 |
High-risk cytogenetics and minimal residual disease (MRD) after chemoimmunotherapy (CIT) predict unfavorable outcome in chronic lymphocytic leukemia (CLL). This phase 2 study investigated risk-adapted CIT in treatment-naive CLL (NCT01145209). Patients with high-risk cytogenetics received induction with fludarabine, cyclophosphamide, and ofatumumab. Those without high-risk cytogenetics received fludarabine and ofatumumab. After induction, MRD positive (MRD+) patients received 4 doses of ofatumumab consolidation. MRD negative (MRD-) patients had no intervention. Of 28 evaluable for response, all responded to induction and 10 (36%) achieved MRD-. Two-year progression-free survival (PFS) was 71.4% (CI95, 56.5-90.3%). There was no significant difference in median PFS between the high-risk and the standard-risk groups. Ofatumumab consolidation didn't convert MRD + to MRD-. In the MRD + group, we saw selective loss of CD20 antigens during therapy. In conclusion, risk-adapted CIT is feasible in treatment-naive CLL. Ofatumumab consolidation didn't improve depth of response in MRD + patients. Loss of targetable CD20 likely reduces efficacy of consolidation therapy.
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