Role of CD20 Monoclonal Antibodies in Previously Untreated Chronic Lymphocytic Leukemia |
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| Authors: | Sameer A Parikh William G Wierda |
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| Institution: | 1. UOC Ematologia, Ospedale Annunziata, Cosenza, Italy;2. Department of Haematology and Oncology, University Medical Centre Freiburg, Freiburg, Germany;3. University of Florence, Florence, Italy;4. Divisione di Ematologia, Università La Sapienza, Roma, Italy;5. Unità di Ematologia, Ospedale Vito Fazzi, Lecce, Italy;6. Hematology Unit, Ospedale S. Gennaro/S. Giovanni Bosco, Napoli, Italy;7. Department of Hematology, Ospedale Santo Spirito, Pescara, Italy;8. Hematology-Oncology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy;9. Consiglio Nazionale delle Ricerche, Istituto di Fisiologia Clinica, Reggio Calabria, Italy;10. Ematologia-Azienda Ospedaliero-Universitaria, Policlinico consorziale di Bari, Italy;11. Department of Biomedical Sciences, Division of Haematology, University of Catania and Ferrarotto Hospital, Catania, Italy;12. Hematology and Transplant Center, Department of Medicine and Surgery, University of Salerno, Salerno, Italy;13. Division of Haematology, University of Torino, A.O. Città della Salute e della Scienza di Torino, Italy;14. Hematology and Bone Marrow Transplant Unit, Dept. of Oncology, La Maddalena, Palermo, Italy;15. Division of Hematology II, San Giovanni Battista Hospital, Torino, Italy;p. Divisione di Ematologia, Ospedale Papardo, Messina, Italy;q. UOC Eatologia Opedale Santa Maria Goretti, Latina, Italy;r. Ospedale “A. Perrino”, Brindisi, Italy;s. Hematology Unit, Cardarelli Hospital, Naples, Italy;t. Department of Hematology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;u. Hematology Institute, Kaplan Medical Center, Rehovot, Israel;v. Hematology Unit, Bnai-Zion Medical Center, Haifa, Israel;w. Haematology Department, Ospedali Riuniti di Ancona, Ancona, Italy;x. Hematology Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy;y. UO Ematologia e CTMO Ospedale Oncologico A. Businco, Cagliari, Italy;z. Haematology Unit, National Cancer Research Centre Istituto Tumori, Bari, Italy;11. Hematology Unit, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola, Italy;12. Unità di Ematologia, Ospedale San Vincenzo, Taormina, Italy;13. Hematology Unit, A.O. of Reggio Calabria, Italy;14. Hematology Unit, Department of Onco-Hematology, Guglielmo da Saliceto Hospital, Piacenza, Italy;15. UOC Ematologia – Ospedale Dimiccoli – Barletta, Barletta, Italy;16. Department of Haematology, ASL Caserta (CE), Hospital Moscati, Aversa, CE, Italy;17. Institute of Hematology, University of Bologna, Bologna, Italy;18. Department of Hematology, Hadassah University, Hospital and Hebrew University Medical School, Jerusalem, Israel;1. Department of Oncology, Hematology and Respiratory Diseases, University Hospital of Modena and Reggio Emilia, Modena, Italy;2. Department of Orthopedics, University Hospital Tübingen, Tübingen, Germany;3. Institute of Clinical and Experimental Transfusion Medicine (IKET), University Hospital Tübingen, Tübingen, Germany;4. Division of Oncology/Blood and Marrow Transplantation, The Children''s Hospital of Philadelphia and The University of Pennsylvania School of Medicine, Philadelphia, PA, USA;5. Department of Neurosurgery, Stanford University School of Medicine, Stanford University, Stanford, CA, USA;1. Division of Hematology-Oncology, Mayo Clinic, Jacksonville, FL, USA;2. Institute of Hematology, Federal Almazov North-West Medical Research Centre, St Petersburg, Russia;3. Department of Internal Medicine, Kaposi Mór Teaching Hospital, Kaspovár, Hungary;4. Department of Haemato-oncology, University Hospital Pilsen, Plzeň, Czech Republic;5. Division of Oncology and Hematology, Pirogov Russian National Research Medical University, Moscow, Russia;6. Department of Oncology, University of Oxford, Oxford, UK;7. Department of Hematology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada;8. Department of Haematology, North Shore Hospital, Auckland, New Zealand;9. Celgene Corporation, Summit, NJ, USA;10. Hematology, Department of Cellular Biotechnologies and Hematology, Policlinico Umberto 1, Sapienza University, Rome, Italy;1. Division of Hematology, Leukemia/BMT Program of BC, Vancouver General Hospital, British Columbia Cancer Agency and University of British Columbia, Vancouver, BC, Canada;2. Cytogenetics Laboratory, Pathology and Laboratory Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada;3. Molecular Cytogenetic Laboratory, Royal Columbian Hospital, New Westminster, BC, Canada;4. Pathology and Laboratory Medicine and Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, Vancouver, BC, Canada;5. Division of Hematology, St. Paul’s Hospital and University of British Columbia, Canada;6. GlaxoSmithKline, Mississauga, Ontario, Canada;1. College of Arts and Sciences, Shanxi Agricultural University, Taigu 030801, China;2. Beijing University of Chinese Medicine, Beijing 100029, China |
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| Abstract: | Monoclonal antibodies (MoAbs) directed against the CD20 antigen on B cells have dramatically altered the treatment landscape for patients with chronic lymphocytic leukemia (CLL). Rituximab, a chimeric mouse/human MoAb, was the first antibody to be approved for the treatment of indolent B-cell lymphomas. Although single-agent, standard-dose rituximab has limited activity as first-line therapy for patients with CLL, it has synergistic therapeutic activity when combined with chemotherapy. Indeed, chemoimmunotherapy with combined fludarabine (F), cyclophosphamide (C), and rituximab was shown to improve both progression-free and overall survival in a randomized phase III clinical trial compared with FC in previously untreated patients with CLL. In this article, we review important clinical trials that have incorporated rituximab with other agents for treatment-naive patients with CLL. We also highlight second- and third-generation CD20 MoAbs approved or in development for the treatment of CLL. |
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