RESUMO
As both fludarabine and rituximab are active against indolent lymphoproliferative disorders, we have studied the combination of fludarabine and rituximab in patients with low-grade lymphoma and chronic lymphocytic leukemia (CLL) in phase I/II fashion. Of 33 patients enrolled, 21(63.6%) had low-grade lymphoma and 12 (36.4%) had CLL. They received fludarabine 30 mg/m2 on days 1-4 and rituximab 125, 250 or 375 mg/m2 on day 5 at intervals of 28 days to a maximum of 8 cycles. Three patients were removed from the study because of rituximab-associated anaphylaxis and four because of prolonged hematopoietic toxicity. Toxicity and responsiveness did not differ at the different dose levels of rituximab. For 29 evaluable patients, responses were seen in 82.8% and complete responses in 34.5%. Of 7 responding patients not referred for stem cell transplantation, 6 remain in complete remission at a median follow-up of 16 months (range 4-30 months). Of 13 previously untreated patients, all responded and 46.2% had a complete response. Of 16 previously treated patients, 68.5% responded and 25% had a complete response. The combination of fludarabine and rituximab has major activity and acceptable toxicity in patients with low-grade lymphoma and CLL.
Assuntos
Anticorpos Monoclonais/uso terapêutico , Antimetabólitos Antineoplásicos/uso terapêutico , Leucemia Linfocítica Crônica de Células B/terapia , Linfoma não Hodgkin/terapia , Vidarabina/análogos & derivados , Vidarabina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anafilaxia/etiologia , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais Murinos , Antimetabólitos Antineoplásicos/efeitos adversos , Terapia Combinada , Feminino , Seguimentos , Doenças Hematológicas/induzido quimicamente , Humanos , Leucemia Linfocítica Crônica de Células B/tratamento farmacológico , Linfoma não Hodgkin/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Transplante de Células-Tronco de Sangue Periférico , Indução de Remissão , Rituximab , Resultado do Tratamento , Vidarabina/administração & dosagem , Vidarabina/efeitos adversosRESUMO
A case of hepatitis in a patient receiving rituximab for ITP is reported. After an extensive workup, no infectious or autoimmune etiology could be found. The authors believe that this represents a case of drug-induced hepatitis, which has not been reported for this agent in the past.