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Chronic Lymphocytic Leukemia (CLL)

Leukemia Insights - Summer 2008

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. 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)

a. Age > 65 yrs - Single-agent Lenalidomide: protocol 2006-0715.
b. Age < 70, beta-2 microglobulin > 3.9 mg/L (high risk) - Fludarabine, Cyclophosphamide, Rituximab, Alemtuzumab (CFAR): protocol 2005-0269.
c. Any age - Fludarabine, Cyclophosphamide, Rituximab + GM-CSF (FCR+GM-CSF): protocol 2006-0267.

Previously Treated (treatment indicated) 

Chemoimmunotherapy

a. Randomized FCR +/- Lumiliximab (anti-CD23mAb): protocol 2006-0789.
b. Fludarabine sensitive - FCR + Bevacizumab: protocol 2005-0992.
c. Oxaliplatin, Fludarabine, Cytarabine, Rituximab (OFAR2): protocol 2006-1026.

Single-Agent Phase I or II

a. Fludarabine and Alemtuzumab refractory (or bulky nodes) - Ofatumumab (HuMax CD20;
anti-CD20 mAb): protocol 2006-0314.
b. 5-Azacitidine (Phase II): protocol 2006-0428.
c. Anti-CD40 mAb (Phase I): protocol 2005-0025.
d. Oral CNF2024 (Hsp90 inhibitor) (Phase I): protocol 2005-0452.
e. SNS-032 (cyclin-dependent kinase inhibitor - Phase I): protocol 2006-0843.
f. Oral Enzastaurin (protein kinase C inhibitor) (Phase II): protocol 2006-0868.

Minimal Residual Disease

a. Revlimid: protocol 2007-0213.

Richter's Transformation

a. Oxaliplatin, Fludarabine, Cytarabine, Rituximab (OFAR2): protocol 2006-1026.


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