| Title |
Fludarabine and rituximab with escalating doses of lenalidomide followed by lenalidomide/rituximab maintenance in previously untreated chronic lymphocytic leukaemia (CLL): the REVLIRIT CLL-5 AGMT phase I/II study
|
|---|---|
| Published in |
Annals of Hematology, June 2018
|
| DOI | 10.1007/s00277-018-3380-z |
| Pubmed ID | |
| Authors |
Alexander Egle, Michael Steurer, Thomas Melchardt, Lukas Weiss, Franz Josef Gassner, Nadja Zaborsky, Roland Geisberger, Kemal Catakovic, Tanja Nicole Hartmann, Lisa Pleyer, Daniela Voskova, Josef Thaler, Alois Lang, Michael Girschikofsky, Andreas Petzer, Richard Greil |
| Abstract |
Despite recent advances, chemoimmunotherapy remains a standard for fit previously untreated chronic lymphocytic leukaemia patients. Lenalidomide had activity in early monotherapy trials, but tumour lysis and flare proved major obstacles in its development. We combined lenalidomide in increasing doses with six cycles of fludarabine and rituximab (FR), followed by lenalidomide/rituximab maintenance. In 45 chemo-naive patients, included in this trial, individual tolerability of the combination was highly divergent and no systematic toxicity determining a maximum tolerated dose was found. Grade 3/4 neutropenia (71%) was high, but only 7% experienced grade 3 infections. No tumour lysis or flare > grade 2 was observed, but skin toxicity proved dose-limiting in nine patients (20%). Overall and complete response rates after induction were 89 and 44% by intention-to-treat, respectively. At a median follow-up of 78.7 months, median progression-free survival (PFS) was 60.3 months. Minimal residual disease and immunoglobulin variable region heavy chain mutation state predicted PFS and TP53 mutation most strongly predicted OS. Baseline clinical factors did not predict tolerance to the immunomodulatory drug lenalidomide, but pretreatment immunophenotypes of T cells showed exhausted memory CD4 cells to predict early dose-limiting non-haematologic events. Overall, combining lenalidomide with FR was feasible and effective, but individual changes in the immune system seemed associated with limiting side effects. clinicaltrials.gov (NCT00738829) and EU Clinical Trials Register ( www.clinicaltrialsregister.eu , 2008-001430-27). |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 32 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 6 | 19% |
| Other | 4 | 13% |
| Professor | 2 | 6% |
| Student > Ph. D. Student | 2 | 6% |
| Researcher | 2 | 6% |
| Other | 5 | 16% |
| Unknown | 11 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 44% |
| Immunology and Microbiology | 2 | 6% |
| Nursing and Health Professions | 1 | 3% |
| Sports and Recreations | 1 | 3% |
| Psychology | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 13 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 June 2018.
All research outputs
#15,535,385
of 23,088,369 outputs
Outputs from Annals of Hematology
#1,175
of 2,206 outputs
Outputs of similar age
#209,835
of 329,877 outputs
Outputs of similar age from Annals of Hematology
#22
of 43 outputs
Altmetric has tracked 23,088,369 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,206 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 36th percentile – i.e., 36% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 329,877 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 43 others from the same source and published within six weeks on either side of this one. This one is in the 44th percentile – i.e., 44% of its contemporaries scored the same or lower than it.