Chronic lymphocytic leukemia accompanied by renal failure
Autor: | B T Dzhumabaeva, L S Biriukova, É G Gemdzhian, S K Kravchenko, A L Melikian, L S Roshchina |
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Jazyk: | ruština |
Rok vydání: | 2014 |
Předmět: | |
Zdroj: | Терапевтический архив, Vol 86, Iss 12, Pp 37-41 (2014) |
Druh dokumentu: | article |
ISSN: | 0040-3660 2309-5342 |
Popis: | AIM. To evaluate the efficiency and safety of monotherapy with bendamustine (B) and therapy with B in combination with rituximab (B + R) in patients with chronic lymphocytic leukemia (CLL) accompanied by renal failure (RF). MATERIALS AND METHODS. The prospective pilot study included 8 patients (6 men, 2 women) with CLL concurrent with RF. The patients' median age was 63 years (51-77 years). The Binet classification stage of CLL corresponded to B in 2 cases and C in 6. The mean (± standard error) pretreatment concentration of creatinine was 218±92 µmol/l and the glomerular filtration rate (GFR) was 33±20 ml/min. The efficiency of monotherapy with B (n=5) and combination therapy with B + R (n=3) was evaluated. In progressive CLL, therapy was performed in specific treatment-naïve patients (n=5) and in pretreated patients refractory to alkylating agents (cyclophosphan, chlorambucil) (n=3). A total of cycles of B and B + R were carried out. RESULTS. After B monotherapy, one of the 5 cases achieved a complete remission, 3 a partial remission, and 1 a nodular partial remission. Three patients developed recurrence. In the B monotherapy group, the cumulative risk of recurrence was 70% at a median follow-up of 22 months and at a maximum follow-up of 27 months. In the B + R therapy group, all the 3 patients achieved a complete remission. The median follow-up was 7 months; the maximum follow-up was 1 year. There were no deaths or recurrences. During B monotherapy and B + R combination therapy, there was improved kidney function: the mean concentration of creatinine decreased from 218±92 to 140±57 µmol/l (p |
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