Enhancing the action of rituximab by adding fresh frozen plasma for the treatment of fludarabine refractory chronic lymphocytic leukemia

• Published in: International journal of cancer Vol. 128; no. 9; pp. 2192 - 2201
• Main Authors: Xu, Wei, Miao, Kou‐Rong, Zhu, Dan‐Xia, Fang, Cheng, Zhu, Hua‐Yuan, Dong, Hua‐Jie, Wang, Dong‐Mei, Wu, Yu‐Jie, Qiao, Chun, Li, Jian‐Yong
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.05.2011; Wiley-Blackwell
• Subjects: Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Biological and medical sciences; CD38 antigen; chronic lymphocytic leukemia; Disease-Free Survival; Drug Resistance, Neoplasm - drug effects; Female; fresh frozen plasma; Hematologic and hematopoietic diseases; Humans; Leukemia, Lymphocytic, Chronic, B-Cell - drug therapy; Leukemia, Lymphocytic, Chronic, B-Cell - mortality; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Male; Medical sciences; Middle Aged; Plasma; Rituximab; salvage therapy; Salvage Therapy - methods; Tumors; Vidarabine - analogs & derivatives; Vidarabine - therapeutic use; Antineoplastic agent; Purine nucleotide; Treatment resistance; Fresh frozen plasma; Rituximab; Malignant hemopathy; Nucleotide analog; Monoclonal antibody; Chronic lymphocytic leukemia; Cancerology; Fludarabine; Antimetabolic; Lymphoproliferative syndrome; Immunotherapy; Fluorine Organic compounds; Salvage treatment; salvage therapy; Cancer
• ISSN: 0020-7136; 1097-0215; 1097-0215
• DOI: 10.1002/ijc.25560

Complement deficiencies have been identified in many chronic lymphocytic leukemia (CLL) patients. Supplying fresh frozen plasma (FFP)‐derived complement can enhance complement‐dependent cell lysis by the rituximab. The objective of our study was to evaluate the clinical efficacy and safety of the treatment by adding FFP to rituximab in fludarabine refractory CLL patients. Twenty‐two patients were treated with two units of FFP followed with rituximab, 375 mg/m2, as a single agent, repeated every 1–2 weeks. Patients received a median of four courses of the combined FFP and rituximab treatment (range: 2–6). Sixteen patients (72.7%) responded to treatment and seven (31.8%) achieved a complete remission. Three (13.6%) of which had no evidence of minimal residual disease after treatment. Patients with high expression of ZAP‐70 or CD38, unmutated immunoglobulin heavy chain variable region, mutated p53, or adverse cytogenetic features, achieved response to treatment at rates that appeared similar to those who did not have such characteristics. With a median follow‐up of 12 (4–19) months, the median overall survival and progression free survival have not been achieved. Toxicity was minimal, and the treatment was well tolerated. Our data suggest that the adding FFP to rituximab is an effective nonmyelotoxic regimen for the treatment of fludarabine refractory CLL patients.