Treatment of autoimmune cytopenia complicating progressive chronic lymphocytic leukemia/small lymphocytic lymphoma with rituximab, cyclophosphamide, vincristine, and prednisone

Deborah A. Bowen, Timothy G. Call, Tait D. Shanafelt, Neil Elliot Kay, Susan M. Schwager, Megan S. Reinalda, Kari G. Rabe, Susan L Slager, Clive S. Zent

Research output: Contribution to journalArticle

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Abstract

Treatment of autoimmune cytopenia complicating progressive chronic lymphocytic leukemia (CLL) is constrained by intolerance of myelosuppression and the risk of exacerbation of autoimmune cytopenia by purine analogs particularly when used as single agents. We report on 20 such patients treated with rituximab, cyclophosphamide, vincristine, and prednisone (R-CVP). Autoimmune cytopenia responded in 19 patients (14 complete remissions (CR), five partial remissions (PR)) with a median time to next treatment (TTT) for autoimmune cytopenia of 21.7 months. Progressive CLL responded in 17 patients (nine CR/complete clinical response, eight PR) with a median TTT of 27.7 months. Five patients have not required any re-treatment at 15-30 months. Grade 3-4 toxicities were infections (n=3) and drug-induced pneumonitis (n=1). No patient required blood cell transfusions after cycle 1 of therapy. We conclude that R-CVP is effective and tolerable therapy for autoimmune cytopenia complicating progressive CLL, but the duration of response is suboptimal.

Original languageEnglish (US)
Pages (from-to)620-627
Number of pages8
JournalLeukemia and Lymphoma
Volume51
Issue number4
DOIs
StatePublished - Apr 2010

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Vincristine
B-Cell Chronic Lymphocytic Leukemia
Prednisone
Cyclophosphamide
Therapeutics
Blood Transfusion
Rituximab
Blood Cells
Pneumonia
Infection
Pharmaceutical Preparations

Keywords

  • Autoimmune hemolytic anemia
  • Chronic lymphocytic leukemia
  • Immune thrombocytopenia
  • Pure red blood cell aplasia
  • Therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Treatment of autoimmune cytopenia complicating progressive chronic lymphocytic leukemia/small lymphocytic lymphoma with rituximab, cyclophosphamide, vincristine, and prednisone. / Bowen, Deborah A.; Call, Timothy G.; Shanafelt, Tait D.; Kay, Neil Elliot; Schwager, Susan M.; Reinalda, Megan S.; Rabe, Kari G.; Slager, Susan L; Zent, Clive S.

In: Leukemia and Lymphoma, Vol. 51, No. 4, 04.2010, p. 620-627.

Research output: Contribution to journalArticle

Bowen, Deborah A. ; Call, Timothy G. ; Shanafelt, Tait D. ; Kay, Neil Elliot ; Schwager, Susan M. ; Reinalda, Megan S. ; Rabe, Kari G. ; Slager, Susan L ; Zent, Clive S. / Treatment of autoimmune cytopenia complicating progressive chronic lymphocytic leukemia/small lymphocytic lymphoma with rituximab, cyclophosphamide, vincristine, and prednisone. In: Leukemia and Lymphoma. 2010 ; Vol. 51, No. 4. pp. 620-627.
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