Cumulative experience and long term follow-up of pentostatin-based chemoimmunotherapy trials for patients with chronic lymphocytic leukemia

Neil E. Kay, Betsy R. LaPlant, Adam M. Pettinger, Timothy G. Call, Jose F. Leis, Wei Ding, Sameer A. Parikh, Michael J. Conte, Deborah A. Bowen, Tait D. Shanafelt

Research output: Contribution to journalArticle

8 Scopus citations

Abstract

Background: 7 regimens of pentostatin based chemoimmunotherapy (CIT) for progressive previously untreated CLL primarily with long term follow-up to update both efficacy and toxicity. Research design and methods: Prognostic markers including assessment of IGVH and FISH status were done on all. Response rates and 95% binomial confidence intervals were calculated for each regimen and in the combined cohort. Overall survival and treatment-free survival were evaluated using Kaplan-Meier methods. Results: The initial CIT trial was pentostatin (2 mgs/m2), cyclophosphamide (600 mg/m2) and rituximab (PCR) but subsequent P based CIT trials with modifications in subsequent trials. The cohort (n = 288) included 52% with unmutated IGVH status and del17p (4.5%) and del11q (14.9%). Toxicity profiles were primarily hematologic and no patient has developed MDS or AML after a median follow-up of 6.4 years. The overall response rate across all trials was found to be over 90% with a 41% complete response rate. We validated that the CLL IPI model segregates progressive CLL patients into 4 risk groups associated with OS and TFS. Conclusions: The high overall and complete response levels in favorable genetic risk CLL along with favorable toxicity profiles provide rationale for consideration of a PC based strategy for previously untreated progressive CLL.

Original languageEnglish (US)
Pages (from-to)337-349
Number of pages13
JournalExpert Review of Hematology
Volume11
Issue number4
DOIs
StatePublished - Apr 3 2018

Keywords

  • Pentostatin
  • chemoimmunotherapy
  • chronic lymphocytic leukemia

ASJC Scopus subject areas

  • Hematology

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