Intensive chemotherapy for progressive chronic lymphocytic leukemia administered early after a nonmyeloablative allograft.


Journal Article

A 51-year-old patient with refractory CLL elected to participate in a trial of nonmyeloablative trans- plantation from an HLA-matched unrelated donor. He received low-dose fludarabine/TBI, with infusion of donor PBPC and cyclosporin (CsA)/MMF. Early post transplant he experienced explosive tumor growth with respiratory insufficiency. After immunosuppression discontinuation and rituximab administration, no response was observed. This prompted treatment with cyclophosphamide (2 g/m(2)/day x 2), paclitaxel (250 mg/m(2) over 24 h), doxorubicin (50 mg/m(2)), solumedrol (500 mg/day), and a second dose of rituximab, from days +11 to +14. A rapid response was achieved. Chemotherapy did not cause an obvious compromise of donor stem cell engraftment or establishment of stable donor chimerism.

Full Text

Duke Authors

Cited Authors

  • Nieto, Y; Bearman, SI; Shpall, EJ; Jones, RB; Cagnoni, PJ; Rabinovitch, RA; McSweeney, PA

Published Date

  • December 2001

Published In

Volume / Issue

  • 28 / 11

Start / End Page

  • 1083 - 1086

PubMed ID

  • 11781620

Pubmed Central ID

  • 11781620

International Standard Serial Number (ISSN)

  • 0268-3369

Digital Object Identifier (DOI)

  • 10.1038/sj.bmt.1703293


  • eng

Conference Location

  • England