Inotuzumab Combined with Mini-Hyper-CVAD in Older Patients with ALL
Leukemia Insights - Spring 2012
Among patients 60 years or older with ALL, hyper-CVAD chemotherapy results in a CR rate of 80 percent, but the regimen is toxic. One-third of patients achieving CR may die of myelosuppression-associated complications, and the long-term cure rate is only 15 to 20 percent. Because of the potency of inotuzumab and its low toxicity profile, we have designed a new regimen combining “mini-hyper-CVAD” with inotuzumab. The chemotherapy doses in mini-hyper-CVAD are 50 percent of the standard doses, and the methotrexate-cytarabine doses are 25 percent of the standard doses. Inotuzumab is added as a single short infusion with each of the first four courses of chemotherapy. It can also be given later for persistent minimal residual disease. This study is ongoing.