Experience With Rituximab Immunotherapy as an Early Intervention in Patients With Rai Stage 0 to II Chronic Lymphocytic Leukemia

BACKGROUND: Management of asymptomatic early stage chronic lymphocytic leukemia (CLL) centered on expectant surveillance for active disease warranting chemotherapy. In CLL, elevated serum beta-2 microglobulin (beta 2M) levels were associated with more rapid disease progression and shorter survival (OS). METHODS: An early intervention trial was designed to assess response, time-to-progression (TTP), and OS after immunotherapy with standard-dose rituximab (375 mg/m(2) intravenously weekly for 8 consecutive weeks) in 34 asymptomatic untreated early stage CLL with beta 2M level >= 2 mg/dL. RESULTS: Long-term follow-up and results are reported. The overall response rate in 34 patients was 82% (9% complete [CR]), median TTP in the 28 responders was 23 months, the median time to subsequent treatment was 43 months, and the 8-year OS rate was 74% (median follow-up, 102 months). CONCLUSIONS: Early treatment with rituximab was well tolerated and safe. Further studies are needed to determine if this intervention can decrease CLL-related morbidity and mortality. Cancer 2011;117:3182-6. (C) 2011 American Cancer Society