High-dose methylprednisolone can induce remissions in patients with fludarabine-refractory chronic lymphocytic leukaemia.
OBJECTIVE
To evaluate the clinical efficacy and safety of high-dose methylprednisolone (HDMP) in patients with fludarabine-refractory chronic lymphocytic leukaemia (CLL).


METHODS
Twelve patients who were refractory to fludarabine-based treatment were treated with 2-6 cycles of HDMP (1g/m(2) for 5days).


RESULTS
Ten patients (83.3%) responded to treatment and three (25.0%) achieved a complete remission (CR). Two (16.7%) of which had no evidence of minimal residual disease (MRD) after treatment. Patients with leukaemia cells that have high expression of ZAP-70 or CD38, unmutated immunoglobulin heavy chain variable region (IGHV), mutated p53 or adverse cytogenetic features achieved response to treatment at rates that appeared similar to those achieved by patients who did not have such disease characteristics. With a median follow-up of 13 (4-30) months, the median overall survival (OS) and the progression-free survival (PFS) have not been achieved. Treatment with HDMP was well tolerated, notably in the patients having poor myeloid reserve and pretreated cytopaenias.


CONCLUSIONS
HDMP is an effective non-myelotoxic regimen for the treatment of patients with fludarabine-refractory CLL.
Xu
Wei
W
Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing 210029, China.
Miao
Kou-Rong
KR
Hong
Ming
M
Zhu
Dan-Xia
DX
Fang
Cheng
C
Dong
Hua-Jie
HJ
Wang
Dong-Mei
DM
Cao
Xin
X
Li
Jian-Yong
JY
D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D012074:Remission Induction / Q000379:methods; D016896:Treatment Outcome; D014740:Vidarabine / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D014740:Vidarabine; C024352:fludarabine; D008775:Methylprednisolone