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Obinutuzumab-Chlorambucil (Chl-G) combination in untreated patients (pts) with chronic lymphocytic leukemia (CLL) and comorbidities, has proven to be safe and more effective than other treatments in the CLL11 study. The Chl dose used in CLL11 was lower than its use in associations with Rituximab in other European experiences; moreover, has emerged that the infusion of G is burdened by a high incidence of infusion-related reactions (IRRs). Given the previous experience of our group, we used, in the same setting of pts of the CLL11, a 2-cycle purging dose of Chl in association with G looking at safety and response, to prevent the occurrence of these adverse events (AE). We retrospectively analysed a pilot cohort of 10 untreated CLL pts with comorbidities, treated with G-Chl regimen. At 2 months after the end of the therapy the overall response rate was 80%. In the safety analysis, grade 3-4 treatment-emergent AE occurred in 50% of pts, but no grade 3-4 IRRs or clinical tumor lysis syndrome have been detected in our cohort. When comparing CBCs before and after the first 2 cycles of Chl, we observed a statistically significant reduction of lymphocytes from a mean of 50.310x10^9/l to 15.710x10^9/l (p=0.034), while no significant differences were detected in haemoglobin levels, neutrophil and platelet counts. Median dose of Chl used was 520 mg for each patient (210-640 mg) with median Chl of 78 mg for each cycle. Our real-life pilot analysis suggests that the use of a Chl purging regimen is a valid option to minimize the IRR, since no grade 3-4 were observed. Toxicities and response rates were like already published experiences. These results are encouraging, but further studies with wider cohorts are needed to confirm them.
This article was published in the following journal.
Name: Hematological oncology
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Techniques for the removal of subpopulations of cells (usually residual tumor cells) from the bone marrow ex vivo before it is infused. The purging is achieved by a variety of agents including pharmacologic agents, biophysical agents (laser photoirradiation or radioisotopes) and immunologic agents. Bone marrow purging is used in both autologous and allogeneic BONE MARROW TRANSPLANTATION.
An eating disorder that is characterized by a cycle of binge eating (BULIMIA or bingeing) followed by inappropriate acts (purging) to avert weight gain. Purging methods often include self-induced VOMITING, use of LAXATIVES or DIURETICS, excessive exercise, and FASTING.
Serological reactions in which an antiserum against one antigen reacts with a non-identical but closely related antigen.
A rare but serious transfusion-related reaction in which fluid builds up in the lungs unrelated to excessively high infusion rate and/or volume (TRANSFUSION-ASSOCIATED CIRCULATORY OVERLOAD). Signs of Transfusion-Related Acute Lung Injury include pulmonary secretions; hypotension; fever; DYSPNEA; TACHYPNEA; TACHYCARDIA; and CYANOSIS.
Use of any infusion therapy on an ambulatory, outpatient, or other non-institutionalized basis.
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