Trial reportAmerican journal of hematology2014
Chemoimmunotherapy for relapsed/refractory and progressive 17p13-deleted chronic lymphocytic leukemia (CLL) combining pentostatin, alemtuzumab, and low-dose rituximab is effective and tolerable and limits loss of CD20 expression by circulating CLL cells.
Trial report in American journal of hematology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
20 citing papers in PubMed, 35 citations in OpenAlex.
- Acalabrutinib and high-frequency low-dose subcutaneous rituximab for initial therapy of chronic lymphocytic leukemia.Blood advances · 2023Trial
- Results of the randomized phase IIB ARCTIC trial of low-dose rituximab in previously untreated CLL.Leukemia · 2017Trial
- A phase II randomized trial comparing standard and low dose rituximab combined with alemtuzumab as initial treatment of progressive chronic lymphocytic leukemia in older patients: a trial of the ECOG-ACRIN cancer research group (E1908).American journal of hematology · 2016Trial
- Efficacy of high-frequency low-dose rituximab and acalabrutinib in chronic lymphocytic leukemia.HemaSphere · 2026Article
- Target cell adhesion limits macrophage phagocytosis and promotes trogocytosis.The Journal of cell biology · 2025Article
- Target cell adhesion limits macrophage phagocytosis and promotes trogocytosis.bioRxiv : the preprint server for biology · 2025Article
- Development of a method for determining xenobiotics in the form of dried blood spots on cotton material and Whatman® 903 cards.Archiwum medycyny sadowej i kryminologii · 2025Article
- Antibody-mediated phagocytosis in cancer immunotherapy.Immunological reviews · 2023Review
- FcγR-Mediated Trogocytosis 2.0: Revisiting History Gives Rise to a Unifying Hypothesis.Antibodies (Basel, Switzerland) · 2022Review
- Identification of a Tumor Immunological Phenotype-Related Gene Signature for Predicting Prognosis, Immunotherapy Efficacy, and Drug Candidates in Hepatocellular Carcinoma.Frontiers in immunology · 2022Article
- Complement Activation in the Treatment of B-Cell Malignancies.Antibodies (Basel, Switzerland) · 2020Review
- Advances in targeted therapy for malignant lymphoma.Signal transduction and targeted therapy · 2020Review
- 17p deletion strongly influences rituximab elimination in chronic lymphocytic leukemia.Journal for immunotherapy of cancer · 2019Article
- Maxed out macs: physiologic cell clearance as a function of macrophage phagocytic capacity.The FEBS journal · 2017Review
- Antibodies That Efficiently Form Hexamers upon Antigen Binding Can Induce Complement-Dependent Cytotoxicity under Complement-Limiting Conditions.Journal of immunology (Baltimore, Md. : 1950) · 2016Article
- Anti-CD20 monoclonal antibody-dependent phagocytosis of chronic lymphocytic leukaemia cells by autologous macrophages.Clinical and experimental immunology · 2016Article
- Interactions between Ibrutinib and Anti-CD20 Antibodies: Competing Effects on the Outcome of Combination Therapy.Clinical cancer research : an official journal of the American Association for Cancer Research · 2016Article
- The anti-leukemic activity of sodium dichloroacetate in p53mutated/null cells is mediated by a p53-independent ILF3/p21 pathway.Oncotarget · 2015Article
- Transplantation in chronic lymphocytic leukemia: does it still matter in the era of novel targeted therapies?Hematology/oncology clinics of North America · 2014Review
- Analyses of CD20 monoclonal antibody-mediated tumor cell killing mechanisms: rational design of dosing strategies.Molecular pharmacology · 2014Review
Corrections and comments
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Authors and funding
17 authors at 4 institutions in 1 country.
Funding
Abstract
Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) patients with purine analog refractory disease or TP53 dysfunction still have limited treatment options and poor survival. Alemtuzumab-containing chemoimmunotherapy regimens can be effective but frequently cause serious infections. We report a Phase II trial testing the efficacy and tolerability of a short-duration regimen combining pentostatin, alemtuzumab, and low-dose high-frequency rituximab designed to decrease the risk of treatment-associated infections and to limit the loss of CD20 expression by CLL cells. The study enrolled 39 patients with progressive CLL that was either relapsed/refractory (n = 36) or previously untreated with 17p13 deletion (17p13-) (n = 3). Thirteen (33%) patients had both 17p13- and TP53 mutations predicted to be dysfunctional, and eight patients had purine analog refractory CLL without TP53 dysfunction. Twenty-six (67%) patients completed therapy, with only five (13%) patients having treatment-limiting toxicity and no treatment-related deaths. Twenty-two (56%) patients responded to treatment, with 11 (28%) complete responses (four with incomplete bone marrow recovery). Median progression-free survival was 7.2 months, time to next treatment was 9.1 months, and overall survival was 34.1 months. The majority of deaths (82%) were caused by progressive disease, including transformed diffuse large B-cell lymphoma (n = 6). Correlative studies showed that low-dose rituximab activates complement and natural killer cells without a profound and sustained decrease in expression of CD20 by circulating CLL cells. We conclude that pentostatin, alemtuzumab, and low-dose high-frequency rituximab is a tolerable and effective therapy for CLL and that low-dose rituximab therapy can activate innate immune cytotoxic mechanisms without substantially decreasing CD20 expression.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.