Intensive chemotherapy for progressive chronic lymphocytic leukemia administered early after a nonmyeloablative allograft

Y. Nieto; S. I. Bearman; E. J. Shpall; R. B. Jones; P. J. Cagnoni; R. A. Rabinovitch; P. A. McSweeney

doi:10.1038/sj.bmt.1703293

Intensive chemotherapy for progressive chronic lymphocytic leukemia administered early after a nonmyeloablative allograft

Y. Nieto, S. I. Bearman, E. J. Shpall, R. B. Jones, P. J. Cagnoni, R. A. Rabinovitch, P. A. McSweeney

Stem Cell Transplantation

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

A 51-year-old patient with refractory CLL elected to participate in a trial of nonmyeloablative transplantation from an HLA-matched unrelated donor. He received low-dose fludarabine/TBI, with infusion of donor PBPC and cyclosporin (CsA)/MMF. Early post transplant he experienced explosive tumor growth with respiratory insufficiency. After immunosuppression discontinuation and rituximab administration, no response was observed. This prompted treatment with cyclophosphamide (2 g/m²/day × 2), paclitaxel (250 mg/m² over 24 h), doxorubicin (50 mg/m²), solumedrol (500 mg/day), and a second dose of rituximab, from days +11 to +14. A rapid response was achieved. Chemotherapy did not cause an obvious compromise of donor stem cell engraftment or establishment of stable donor chimerism.

Original language	English (US)
Pages (from-to)	1083-1086
Number of pages	4
Journal	Bone marrow transplantation
Volume	28
Issue number	11
DOIs	https://doi.org/10.1038/sj.bmt.1703293
State	Published - 2001

Keywords

Chimerism
Chronic lymphocytic leukemia
Graft-versus-leukemia
Graft-versus-tumor
Nonmyeloablative transplant

ASJC Scopus subject areas

Hematology
Transplantation

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title = "Intensive chemotherapy for progressive chronic lymphocytic leukemia administered early after a nonmyeloablative allograft",

abstract = "A 51-year-old patient with refractory CLL elected to participate in a trial of nonmyeloablative transplantation from an HLA-matched unrelated donor. He received low-dose fludarabine/TBI, with infusion of donor PBPC and cyclosporin (CsA)/MMF. Early post transplant he experienced explosive tumor growth with respiratory insufficiency. After immunosuppression discontinuation and rituximab administration, no response was observed. This prompted treatment with cyclophosphamide (2 g/m2/day × 2), paclitaxel (250 mg/m2 over 24 h), doxorubicin (50 mg/m2), solumedrol (500 mg/day), and a second dose of rituximab, from days +11 to +14. A rapid response was achieved. Chemotherapy did not cause an obvious compromise of donor stem cell engraftment or establishment of stable donor chimerism.",

keywords = "Chimerism, Chronic lymphocytic leukemia, Graft-versus-leukemia, Graft-versus-tumor, Nonmyeloablative transplant",

author = "Y. Nieto and Bearman, {S. I.} and Shpall, {E. J.} and Jones, {R. B.} and Cagnoni, {P. J.} and Rabinovitch, {R. A.} and McSweeney, {P. A.}",

year = "2001",

doi = "10.1038/sj.bmt.1703293",

language = "English (US)",

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AU - Nieto, Y.

AU - Bearman, S. I.

AU - Shpall, E. J.

AU - Jones, R. B.

AU - Cagnoni, P. J.

AU - Rabinovitch, R. A.

AU - McSweeney, P. A.

PY - 2001

Y1 - 2001

N2 - A 51-year-old patient with refractory CLL elected to participate in a trial of nonmyeloablative transplantation from an HLA-matched unrelated donor. He received low-dose fludarabine/TBI, with infusion of donor PBPC and cyclosporin (CsA)/MMF. Early post transplant he experienced explosive tumor growth with respiratory insufficiency. After immunosuppression discontinuation and rituximab administration, no response was observed. This prompted treatment with cyclophosphamide (2 g/m2/day × 2), paclitaxel (250 mg/m2 over 24 h), doxorubicin (50 mg/m2), solumedrol (500 mg/day), and a second dose of rituximab, from days +11 to +14. A rapid response was achieved. Chemotherapy did not cause an obvious compromise of donor stem cell engraftment or establishment of stable donor chimerism.

AB - A 51-year-old patient with refractory CLL elected to participate in a trial of nonmyeloablative transplantation from an HLA-matched unrelated donor. He received low-dose fludarabine/TBI, with infusion of donor PBPC and cyclosporin (CsA)/MMF. Early post transplant he experienced explosive tumor growth with respiratory insufficiency. After immunosuppression discontinuation and rituximab administration, no response was observed. This prompted treatment with cyclophosphamide (2 g/m2/day × 2), paclitaxel (250 mg/m2 over 24 h), doxorubicin (50 mg/m2), solumedrol (500 mg/day), and a second dose of rituximab, from days +11 to +14. A rapid response was achieved. Chemotherapy did not cause an obvious compromise of donor stem cell engraftment or establishment of stable donor chimerism.

KW - Chimerism

KW - Chronic lymphocytic leukemia

KW - Graft-versus-leukemia

KW - Graft-versus-tumor

KW - Nonmyeloablative transplant

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JO - Bone marrow transplantation

JF - Bone marrow transplantation

IS - 11

ER -

Intensive chemotherapy for progressive chronic lymphocytic leukemia administered early after a nonmyeloablative allograft

Abstract

Keywords

ASJC Scopus subject areas

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