Neoplasms

Blood and Lymph Conditions

All Conditions

Immune System Diseases

Symptoms and General Pathology

Rare Diseases

Leukemia

Leukemia, Lymphoid

Leukemia, Lymphocytic, Chronic, B-Cell

Neoplasms by Histologic Type

Hematologic Diseases

Lymphoproliferative Disorders

Lymphatic Diseases

Immunoproliferative Disorders

Leukemia, B-Cell

Chronic Disease

Disease Attributes

Chronic Graft Versus Host Disease

Chronic Lymphocytic Leukemia

Antineoplastic Agents

Antirheumatic Agents

All Drugs and Chemicals

Anti-Inflammatory Agents

Cyclophosphamide

Prednisone

Rituximab

Vincristine

Alemtuzumab

Antineoplastic Agents, Immunological

Immunologic Factors

Four Rituximab - CHOP courses will be given The courses will be given every 21 days Drug Dose Day Rituximab (Mabthera) 500mg/m2 1(\*) (\*\*) Cyclophosphamide 750mg/m2 1 Adriamycin 50mg/m2 1 Vincristine 1,4 mg/m2 1 Prednisone 60mg/m2 1 to 5

(\*\*) 1st course, 375 mg/m2 (\*) If lymphocyte count is \> 30 X 10 9/l, dose will be split up in two, which will be given in days 0 and 1

Four Rituximab - CHOP courses will be given The courses will be given every 21 days

Rituximab-CHOP-Alemtuzumab

Francesc Bosch, MD, PhD

Since there is no standard rescue therapy for refractory CLL or relapsed to the purine analogous, our target is to carry out a rescue therapy combining several chemotherapy agents (CHOP) adding the synergistic effect of Rituximab in order to act against tumour-like CLL forms, with assessable size lymph nodes. Afterwards, based in other studies, we shall study the role of Alemtuzumab as drug for consolidation or improvement of responses obtained with the initial therapy (CHOP-R), acting by "cleaning" from peripheral blood and bone marrow the CLL lymphocytes that may have had remain as residual after chemotherapy induction therapy. More precisely, the addition of Alemtuzumab as maintenance treatment would increase the complete responses with negative residual disease number and may prolong the duration of the response. For this, it is necessary to have not only an adequate and rigorous clinical follow-up but also biological, i.e. being able to analyze minimal residual disease by molecular biology techniques. This is the reason of writing this phase II clinical trial protocol.

OBJECTIVES

The objectives of this clinical trial are the following:

* Main objective of the study: Overall response rate obtained after R-CHOP regime followed by Alemtuzumab consolidation as second line therapy
* Secondary objectives

  * Determine the molecular complete response rate after R-CHOP regimen
  * Determine the efficacy of Alemtuzumab in response improvement after R-CHOP regimen: conversion of PR to CR and of MRD+ to MRD-.
  * Applicability (toxicity profile) of Alemtuzumab consolidation therapy.
  * As additional objectives will be considered:

    1. Prognostic value of several biological variables (ZAP-70 and cytogenetics) having influence on the response
    2. Response duration
    3. Progression free survival
    4. Overall survival

R-CHOP and Alemtuzumab in Patients With Chronic Lymphocytic Leukemia

Rescue Treatment With Rituximab-CHOP Therapy and Alemtuzumab (R-CHOP-A) in Refractory or Recidivant Patients With Chronic Lymphocytic Leukemia After Purine-analogous Treatment

Spots Global Cancer Trial Database for patients relapsed with purines therapy