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  • 1
    ISSN: 1569-8041
    Keywords: CD20 ; chimeric IDEC-C2B8 ; lymphoma ; monoclonal antibody ; pharmacokinetics ; feasibility study
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: In clinical trials in the USA, IDEC-C2B8 (a mouse-humanchimeric anti-CD20 monoclonal antibody) has demonstrated high response rateswith only mild toxic effects in relapsed B-cell lymphoma at a dose of fourweekly 375 mg/m2 infusions. The aim of the present trial wasto determine whether or not this dose is practically applicable to Japanesepatients with relapsed B-cell lymphoma with respect to safety,pharmacokinetics and efficacy. Patients and methods: Patients with relapsed CD20+ B-cell lymphomareceived intravenous infusions of IDEC-C2B8 once a week for four weeks. Atotal of 12 patients (four at 250 mg/m2 and eight at 375mg/m2) were enrolled. Results: All 11 eligible patients treated with either dose leveltolerated IDEC-C2B8 well. Commonly observed adverse drug reactions weregrades 1 or 2 non-hematologic toxicities during the infusion, consistingmostly of flu-like symptoms and skin reactions. All of the observedhematologic toxicities were of grade 3 or less, and transient. A rapid andsustained B-cell decrease in peripheral blood was observed, but noinfectious episodes were encountered. Human anti-mouse and anti-chimericantibodies were not detected. Of the 11 eligible patients (eight withfollicular, two with diffuse large-cell and one with mantle cell lymphoma),two showed a complete response and five showed a partial response, and allof the seven responders had lymphoma with follicular histology. Apharmacokinetic analysis showed that the elimination half-life (T1/2) ofIDEC-C2B8 was 445 ± 361 hours, and that the serum antibody levelsincreased in parallel with the course of infusions, and in most patients wasstill measurable at three months. Conclusions: The dose of four weekly 375 mg/m2 infusionsof IDEC-C2B8 is safe and effective in Japanese patients with relapsed B-celllymphoma. Further studies evaluating IDEC-C2B8 are warranted.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1569-8041
    Keywords: cyclophosphamide ; dose intensity ; doxorubicin
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background:CHOP is accepted as the gold standard for first linechemotherapy of aggressive non-Hodgkin's lymphoma (NHL). A dose-escalationstudy of CHOP was conducted to determine the maximal tolerated dose (MTD) andtoxicity profile of CHOP at three-week intervals with or without prophylacticrecombinant human granulocyte colony-stimulating factor (rHuG-CSF) in patientswith aggressive NHL. Patients and methods:The doses of drugs were escalated from 50mg/m2 to 70 mg/m2 for doxorubicin and from 750mg/m2 to 2250 mg/m2 for cyclophosphamide, withconventional doses of vincristine and oral prednisolone. After the MTD wasdetermined without rHuG-CSF, dose escalation was conducted with prophylacticrHuG-CSF. Results:Thirty-three patients with NHL were enrolled into thestudy. The MTD without prophylactic rHuG-CSF was 70 mg/m2 ofdoxorubicin and 1250 mg/m2 of cyclophosphamide, with neutropeniaas a dose-limiting toxicity. The MTD with prophylactic rHuG-CSF was 70mg/m2 of doxorubicin and 2250 mg/m2 of cyclophosphamide.The overall response rate was 100% (76% complete response and24% partial response). Progression-free survival and overall survivalat five years were 45% and 66%, respectively. Conclusions:Significant dose escalation of doxorubicin andcyclophosphamide was feasible with prophylactic rHuG-CSF. The efficacy ofdose-escalated CHOP should be compared with that of standard CHOP.
    Type of Medium: Electronic Resource
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