TY - JOUR
T1 - Adding fresh frozen plasma to rituximab for the treatment of patients with refractory advanced CLL
AU - Klepfish, Abraham
AU - Rachmilewitz, E. A.
AU - Kotsianidis, I.
AU - Patchenko, P.
AU - Schattner, Ami
PY - 2008
Y1 - 2008
N2 - Background: Many patients with chronic lymphocytic leukaemia (CLL) develop progressive, treatment-resistant disease. Rituximab (RTX), a monoclonal antibody targeting CD20 on B lymphocytes and widely used in other indolent B cell neoplasms is less efficacious in CLL, possibly due to associated complement deficiencies. Objective: To examine in open trial whether providing complement by concurrent administration of fresh frozen plasma (FFP) will enhance the effect of RTX in CLL. Setting: Outpatient haematology clinics in Israel and Greece. Patients: Five patients with severe treatment-resistant CLL. All had been previously treated with fludarabine and three also failed treatment with RTX. Intervention: Two units of FFP followed with RTX 375 mg/m2 as a single agent, repeated every 1-2 weeks, as needed. Results: A rapid and dramatic clinical and laboratory response was achieved in all patients. Lymphocyte counts dropped markedly followed by shrinkage of lymph nodes and spleen and improvement of the anaemia and thrombocytopenia. This could be maintained over 8 months (median) with additional cycles if necessary. Treatment was well tolerated in all cases. Conclusion: Adding FFP to RTX may provide a useful therapeutic option in patients with advanced CLL resistant to treatment.
AB - Background: Many patients with chronic lymphocytic leukaemia (CLL) develop progressive, treatment-resistant disease. Rituximab (RTX), a monoclonal antibody targeting CD20 on B lymphocytes and widely used in other indolent B cell neoplasms is less efficacious in CLL, possibly due to associated complement deficiencies. Objective: To examine in open trial whether providing complement by concurrent administration of fresh frozen plasma (FFP) will enhance the effect of RTX in CLL. Setting: Outpatient haematology clinics in Israel and Greece. Patients: Five patients with severe treatment-resistant CLL. All had been previously treated with fludarabine and three also failed treatment with RTX. Intervention: Two units of FFP followed with RTX 375 mg/m2 as a single agent, repeated every 1-2 weeks, as needed. Results: A rapid and dramatic clinical and laboratory response was achieved in all patients. Lymphocyte counts dropped markedly followed by shrinkage of lymph nodes and spleen and improvement of the anaemia and thrombocytopenia. This could be maintained over 8 months (median) with additional cycles if necessary. Treatment was well tolerated in all cases. Conclusion: Adding FFP to RTX may provide a useful therapeutic option in patients with advanced CLL resistant to treatment.
UR - http://www.scopus.com/inward/record.url?scp=51049121811&partnerID=8YFLogxK
U2 - 10.1093/qjmed/hcn085
DO - 10.1093/qjmed/hcn085
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C2 - 18650226
AN - SCOPUS:51049121811
SN - 1460-2725
VL - 101
SP - 737
EP - 740
JO - QJM: An International Journal of Medicine
JF - QJM: An International Journal of Medicine
IS - 9
ER -