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Chronic Lymphocytic Leukemia (CLL)

Leukemia Insights - Spring 2007

Significant success and advance has been made with combination therapies for patients with CLL, particularly chemoimmunotherapy. Fludarabine, cyclophosphamide, and rituxan (FCR) has produced excellent results and is our backbone of CLL therapy at M. D. Anderson. Efforts are now focused on developing active and well tolerated regimens for patients over 65 years old. Current or planned clinical trials for patients with CLL are indicated below.

Previously Untreated (treatment indicated)

  • Age > 65 yrs - Single-agent Lenalidomide - protocol 2005-0175
  • Age < 70, beta-2 microglobulin > 3.9 mg/L (high risk) - Fludarabine, Cyclophosphamide,
    Rituximab, Alemtuzumab (CFAR) - protocol 2005-0269
  • Any age - Fludarabine, Cyclophosphamide, Rituximab + GM-CSF (FCR+GM-CSF) - protocol 2006-0267

Previously Treated (treatment indicated)

Chemoimmunotherapy

  • Randomized FCR +/- Lumiliximab (anti-CD23 mAb) - protocol 2006-0789 (pending)
  • Fludarabine sensitive - FCR + Bevacizumab – protocol 2005-0992
  • Oxaliplatin, Fludarabine, Cytarabine, Rituximab (OFAR2) - protocol 2006-1026 (pending)

Single-Agent Phase I or II

  • Fludarabine and Alemtuzumab refractory (or bulky nodes) - Ofatumumab (HuMax CD20; anti-CD20 mAb) - protocol 2006-0314
  • Dasatinib (Phase II) - protocol 2005-0497
  • 5-Azacitidine (Phase II) - protocol 2006-0428
  • Anti-CD40 mAb (Phase I) - protocol 2005-0025
  • Oral CNF2024 (Hsp90 inhibitor) (Phase I) - protocol 2005-0452
  • Clofarabine (Phase I) - protocol 2004-0134
  • SNS-032 (cyclin-dependent kinase inhibitor - Phase I) - protocol 2006-0843 (pending)
  • Oral Enzastaurin (protein kinase C inhibitor) (Phase II) - protocol 2006-0868 (pending)

Minimal Residual Disease

  • Subcutaneous Alemtuzumab - protocol 2003-0834
  • Randomized Rituximab vs Alemtuzumab vs Rituximab+Alemtuzumab - protocol 2006-0767 (pending)

Richter’s Transformation

  • Oxaliplatin, Fludarabine, Cytarabine, Ritiximab (OFAR2) - protocol 2006-1026 (pending)

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