Publications by authors named "S Wittebol"
Early data on venetoclax-containing regimens for the treatment of chronic lymphocytic leukemia (CLL) show promising results with deep remissions, but are hampered by potential risk for tumor lysis syndrome (TLS). Whether optimal duration of venetoclax treatment can be guided by minimal residual disease (MRD) is currently unknown. To study whether TLS risk can be mitigated in an unfit population by introducing preinduction, and whether MRD-guided duration of venetoclax treatment is a feasible and efficacious approach, we performed the Dutch-Belgian Cooperative Trial Group for Hemato-oncology (HOVON) 139/GIVE trial.
View Article and Find Full Text PDFFeasibility and efficacy of addition of individualized-dose lenalidomide to chlorambucil and rituximab as first-line treatment in elderly and FCR-unfit patients with advanced chronic lymphocytic leukemia.
Haematologica
January 2019
Article Synopsis
- Lenalidomide is effective in treating chronic lymphocytic leukemia (CLL) but has a challenging toxicity profile, which can impact combination treatments.
- A phase 1-2 study evaluated a treatment regimen combining chlorambucil, rituximab, and variable doses of lenalidomide, showing that 89% of patients completed the initial treatment cycle, with an 83% overall response rate and a median progression-free survival of 49 months.
- While some significant toxicities were observed, including high rates of neutropenia, the study concluded that lenalidomide combined with chemotherapy and sequential monotherapy achieves promising remission rates and manageable toxicity through individualized dosing.
CD52 is a glycoprotein expressed on normal as well as leukemic immune cells and shed as soluble CD52 (sCD52). We studied sCD52 levels in three CLL cohorts: the 'early', the 'high-risk', and the 'ibrutinib-treated'. The 'high-risk' patients had significantly higher sCD52 levels than the 'early' patients.
View Article and Find Full Text PDFIn the HOVON68 CLL trial, patients 65 to 75 years of age had no survival benefit from the addition of low-dose alemtuzumab to fludarabine and cyclophosphamide (FC) in contrast to younger patients. The reasons are explored in this 5-year trial update using both survival analysis and competing risk analysis on non-CLL-related mortality. Elderly FCA patients died more frequently from causes not related to CLL, and more often related to comorbidity (mostly cardiovascular) than to infection.
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