Ferrajoli Alessandra, Lee Bang-Ning, Schlette Ellen J, O'Brien Susan M, Gao Hui, Wen Sijin, Wierda William G, Estrov Zeev, Faderl Stefan, Cohen Evan N, Li Changping, Reuben James M, Keating Michael J
Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1402, USA.
Blood. 2008 Jun 1;111(11):5291-7. doi: 10.1182/blood-2007-12-130120. Epub 2008 Mar 11.
This study investigated the activity of lenalidomide in patients with relapsed/refractory chronic lymphocytic leukemia (CLL). Lenalidomide was given at 10 mg daily with dose escalation up to 25 mg daily. Three patients (7%) achieved a complete response (CR), one a nodular partial remission, and 10 patients a partial remission (PR), for an overall response (OR) rate of 32%. Treatment with lenalidomide was associated with an OR rate of 31% in patients with 11q or 17p deletion, of 24% in patients with unmutated V(H), and of 25% in patients with fludarabine-refractory disease. The most common toxicity was myelosuppression, and the median daily dose of lenalidomide tolerated was 10 mg. Plasma levels of angiogenic factors, inflammatory cytokines, and cytokine receptors were measured at baseline, day 7, and day 28. There was a dramatic increase in median interleukin (IL)-6, IL-10, IL-2, and tumor necrosis factor receptor-1 levels on day 7, whereas no changes were observed in median vascular endothelial growth factor levels (20 patients studied). According to our experience, lenalidomide given as a continuous treatment has antitumor activity in heavily pretreated patients with CLL.
本研究调查了来那度胺在复发/难治性慢性淋巴细胞白血病（CLL）患者中的活性。来那度胺的给药剂量为每日10 mg，剂量可递增至每日25 mg。3例患者（7%）达到完全缓解（CR），1例为结节性部分缓解，10例患者为部分缓解（PR），总缓解（OR）率为32%。来那度胺治疗在11q或17p缺失的患者中的OR率为31%，在未突变V(H)的患者中为24%，在氟达拉滨难治性疾病患者中为25%。最常见的毒性是骨髓抑制，来那度胺的耐受中位日剂量为10 mg。在基线、第7天和第28天测量血管生成因子、炎性细胞因子和细胞因子受体的血浆水平。在第7天，白细胞介素（IL）-6、IL-10、IL-2和肿瘤坏死因子受体-1的中位水平显著升高，而血管内皮生长因子的中位水平未观察到变化（研究了20例患者）。根据我们的经验，持续给予来那度胺对CLL的重度预处理患者具有抗肿瘤活性。
