Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia

Background. Intravenous alemtuzumab and fludarabine are effective in combination for the treatment of chronic lymphocytic leukemia (CLL), but require hospital visits for intravenous injection. We performed a pilot study to assess the safety and efficacy of outpatient-based oral fludarabine with subc...

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Main Authors: William Y. K. Hwang, Claire Dearden, Yvonne S. M. Loh, Yeh C. Linn, Sim L. Tien, Gerrard K. H. Teoh, Gee F. How, Kee K. Heng, Yeow T. Goh, Lai H. Lee
Format: Article
Language:English
Published: Wiley 2009-01-01
Series:Advances in Hematology
Online Access:http://dx.doi.org/10.1155/2009/547582
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author William Y. K. Hwang
Claire Dearden
Yvonne S. M. Loh
Yeh C. Linn
Sim L. Tien
Gerrard K. H. Teoh
Gee F. How
Kee K. Heng
Yeow T. Goh
Lai H. Lee
author_facet William Y. K. Hwang
Claire Dearden
Yvonne S. M. Loh
Yeh C. Linn
Sim L. Tien
Gerrard K. H. Teoh
Gee F. How
Kee K. Heng
Yeow T. Goh
Lai H. Lee
author_sort William Y. K. Hwang
collection DOAJ
description Background. Intravenous alemtuzumab and fludarabine are effective in combination for the treatment of chronic lymphocytic leukemia (CLL), but require hospital visits for intravenous injection. We performed a pilot study to assess the safety and efficacy of outpatient-based oral fludarabine with subcutaneous alemtuzumab (OFSA) for the treatment of relapsed/refractory CLL. Results. Depending on their response, patients were given two to six 28-day cycles of subcutaneous alemtuzumab 30 mg on days 1,3, and 5 and oral fludarabine 40 mg/m2/day for 5 days. Median patient age was 74. The lymphocyte counts of all five patients fell after the 1st cycle of treatment and reached normal/low levels on completion of 2 to 6 cycles of therapy. Platelet counts and hemoglobin were unaffected. All five patients achieved complete hematological remission, while two attained minimal residual disease negativity on 4-color flow cytometry. Conclusions. Our OFSA regimen was effective in elderly Asian patients with relapsed/refractory CLL, and it should be investigated further.
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spelling doaj-art-bfed2f99fbb24c44993abe67a038ff452025-08-20T02:19:26ZengWileyAdvances in Hematology1687-91041687-91122009-01-01200910.1155/2009/547582547582Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic LeukemiaWilliam Y. K. Hwang0Claire Dearden1Yvonne S. M. Loh2Yeh C. Linn3Sim L. Tien4Gerrard K. H. Teoh5Gee F. How6Kee K. Heng7Yeow T. Goh8Lai H. Lee9Department of Hematology, Singapore General Hospital, 169608, SingaporeCLL Unit, Royal Marsden Hospital, London SW3 6JJ, UKDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeDepartment of Hematology, Singapore General Hospital, 169608, SingaporeBackground. Intravenous alemtuzumab and fludarabine are effective in combination for the treatment of chronic lymphocytic leukemia (CLL), but require hospital visits for intravenous injection. We performed a pilot study to assess the safety and efficacy of outpatient-based oral fludarabine with subcutaneous alemtuzumab (OFSA) for the treatment of relapsed/refractory CLL. Results. Depending on their response, patients were given two to six 28-day cycles of subcutaneous alemtuzumab 30 mg on days 1,3, and 5 and oral fludarabine 40 mg/m2/day for 5 days. Median patient age was 74. The lymphocyte counts of all five patients fell after the 1st cycle of treatment and reached normal/low levels on completion of 2 to 6 cycles of therapy. Platelet counts and hemoglobin were unaffected. All five patients achieved complete hematological remission, while two attained minimal residual disease negativity on 4-color flow cytometry. Conclusions. Our OFSA regimen was effective in elderly Asian patients with relapsed/refractory CLL, and it should be investigated further.http://dx.doi.org/10.1155/2009/547582
spellingShingle William Y. K. Hwang
Claire Dearden
Yvonne S. M. Loh
Yeh C. Linn
Sim L. Tien
Gerrard K. H. Teoh
Gee F. How
Kee K. Heng
Yeow T. Goh
Lai H. Lee
Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia
Advances in Hematology
title Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia
title_full Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia
title_fullStr Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia
title_full_unstemmed Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia
title_short Outpatient-Based Therapy of Oral Fludarabine and Subcutaneous Alemtuzumab for Asian Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia
title_sort outpatient based therapy of oral fludarabine and subcutaneous alemtuzumab for asian patients with relapsed refractory chronic lymphocytic leukemia
url http://dx.doi.org/10.1155/2009/547582
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