Induction of long-term remission of a relapsed childhood B-acute lymphoblastic leukemia with rituximab chimeric anti-CD20 monoclonal antibody and autologous stem cell transplantation.
ABSTRACT Childhood B-cell neoplasms account for approximately 2% of childhood acute lymphoblastic leukemia (ALL). The short but intensive chemotherapy yields a currently 75% to 85% event-free survival. The prognosis for children with relapsed disease is considered to be dismal. We report a 12-year old boy diagnosed with B-cell ALL with central nervous system (CNS) involvement. He relapsed in the bone marrow immediately after primary chemotherapy. Rituximab as a single agent achieved a complete morphologic remission. After 4 treatments with rituximab an isolated CNS relapse occurred. CNS remission was reinduced with chemotherapy and the patient received an autologous transplant with rituximab for in vivo purging. He is currently in complete clinical and molecular remission for more than 1 year.
Article: A phase II trial of arsenic trioxide for relapsed and refractory acute lymphoblastic leukemia.[show abstract] [hide abstract]
ABSTRACT: We designed a phase II trial of arsenic trioxide (AT) for the treatment of relapsed and refractory acute lymphoblastic leukemia (ALL). The dose administered was 0.25 mg/kg/day intravenously for 5-7 days per week for up to 60 days. Of 11 patients eligible, eight had B-cell and three T-cell ALL and two were Philadelphia chromosome-positive. The median duration of therapy was 21 days (range 7-28). One patient died of an infection. There were no responses. Ten patients have died. The median survival was 3.2 months (range 1.2-4.1). We conclude that AT is not active in the treatment of ALL.Haematologica 09/2006; 91(8):1105-8. · 6.42 Impact Factor
Article: Fatal course after administration of rituximab in a boy with relapsed all: a case report and review of literature.[show abstract] [hide abstract]
ABSTRACT: We are reporting on a 14-year-old boy with a very early relapse of pre-B acute lymphoblastic leukemia (ALL) and anaplastic astrocytoma WHO degrees III; the astrocytoma was subtotally resected and subsequently treated with irradiation and chemotherapy. The leukemic relapse was refractory to the administered salvage therapy. Therefore, treatment with the human anti-CD20 monoclonal antibody (MoAb) IDEC-C2B8 (rituximab) was initiated. After a small fraction of the standard dose (375 mg/m(2)) had been administered, the infusion had to be interrupted because of an acute attack of pain in the lumbar region. Two days later, after resumption of the therapy, he developed a fatal course of systemic inflammatory response syndrome (SIRS) and died, possibly due to uncontrollable cytokine release syndrome associated with sepsis. The fatal course will be discussed based on a review of the literature.Haematologica 07/2006; 91(6 Suppl):ECR23. · 6.42 Impact Factor
Article: Rituximab plus chemotherapy in children with relapsed or refractory CD20-positive B-cell precursor acute lymphoblastic leukemia.[show abstract] [hide abstract]
ABSTRACT: We treated three children with relapsed or refractory CD20 positive B-cell precursor acute lymphoblastic leukemia with rituximab in combination with chemotherapy, which produced a decreasing or persistent low positive minimal residual disease load. Two children subsequently underwent allogeneic stem cell transplantation and remain in complete remission at days +399 and +332.Haematologica 03/2006; 91(2):272-3. · 6.42 Impact Factor