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Abstract Although B-cell chronic lymphocytic leukemia (CLL) is treatable, it remains an incurable disease and most patients inevitably
suffer relapse. Many therapeutic options exist for those requiring therapy, including monoclonal antibodies and stem cell
transplantation, but remissions tend to last shorter in the course of the disease. Targeting the cell cycle has recently been
realized to be an attractive therapeutic approach in solid and hematological malignancies, and the proliferative nature of
B-CLL is increasingly accepted. Here, we report data on a phase II pilot trial with the oral mammalian target of rapamycin
(mTOR) inhibitor RAD001 5 mg/daily in patients with advanced B-CLL who had progressive disease after at least two lines of
treatment. After treatment of seven patients, this trial was stopped because of toxicity concerns, although some degree of
activity was observed (one partial remission, three patients with stable disease). Interestingly, cyclin E expression decreased
in responding patients. Further strategies of mTOR inhibition by RAD001 in B-CLL should focus on different treatment schedules,
adequate anti-infectious prophylaxis, or combinations with cytotoxic drugs.
Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00277-008-0582-9Authors
Thomas Decker, Technical University of Munich III. Department of Medicine Ismaningerstr. 15 81675 Munich GermanyMichael Sandherr, Onkologische Gemeinschaftspraxis Weilheim Weilheim GermanyKatharina Goetze, Technical University of Munich III. Department of Medicine Ismaningerstr. 15 81675 Munich GermanyMadlen Oelsner, Technical University of Munich III. Department of Medicine Ismaningerstr. 15 81675 Munich GermanyIngo Ringshausen, Technical University of Munich III. Department of Medicine Ismaningerstr. 15 81675 Munich GermanyChristian Peschel, Technical University of Munich III. Department of Medicine Ismaningerstr. 15 81675 Munich Germany
Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555 (Source: Annals of Hematology)
Source: Annals of Hematology - Thursday, August 14, 2008
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IntroductionTreatment of chronic lymphocytic leukemia of the B-cell-lineage is strongly based upon clinical staging because of the heterogeneous clinical course of this disease. Case presentationWe describe a 62-year-old patient with newly diagnosed chronic lymphocytic leukemia of the B-cell-lineage who did not respond to several chemotherapy regimens including chlorambucil, fludarabine and cyclophosphamide, developing a marked neutropenia and thrombocytopenia with life-threatening infections. Further chemotherapy appeared not feasible because of bone marrow toxicity. The patient was treated with 600mg/m2 rituximab weekly followed by eight courses of biweekly therapy and then by long-term maintenance therapy, achieving almost complete remission of the symptoms and disease control.
Conclusions:
After resistance to standard chemotherapy with chlorambucil and fludarabine, a patient with chronic lymphocytic leukemia of the B-cell-lineage was successfully treated with rituximab. (Source: Journal of Medical Case Reports)
Source: Journal of Medical Case Reports - Wednesday, August 13, 2008
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