Since there is no standard rescue therapy for refractory CLL or relapsed to the purine analogous, our target is to carry out a rescue therapy combining several chemotherapy agents (CHOP) adding the synergistic effect of Rituximab in order to act against tumour-like CLL forms, with assessable size lymph nodes. Afterwards, based in other studies, we shall study the role of Alemtuzumab as drug for consolidation or improvement of responses obtained with the initial therapy (CHOP-R), acting by "cleaning" from peripheral blood and bone marrow the CLL lymphocytes that may have had remain as residual after chemotherapy induction therapy. More precisely, the addition of Alemtuzumab as maintenance treatment would increase the complete responses with negative residual disease number and may prolong the duration of the response. For this, it is necessary to have not only an adequate and rigorous clinical follow-up but also biological, i.e. being able to analyze minimal residual disease by molecular biology techniques. This is the reason of writing this phase II clinical trial protocol.
OBJECTIVES The objectives of this clinical trial are the following: * Main objective of the study: Overall response rate obtained after R-CHOP regime followed by Alemtuzumab consolidation as second line therapy * Secondary objectives * Determine the molecular complete response rate after R-CHOP regimen * Determine the efficacy of Alemtuzumab in response improvement after R-CHOP regimen: conversion of PR to CR and of MRD+ to MRD-. * Applicability (toxicity profile) of Alemtuzumab consolidation therapy. * As additional objectives will be considered: 1. Prognostic value of several biological variables (ZAP-70 and cytogenetics) having influence on the response 2. Response duration 3. Progression free survival 4. Overall survival
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Four Rituximab - CHOP courses will be given The courses will be given every 21 days
Hospital de Son Dureta
Palma de Mallorca, Balearic Islands, Spain
ICO Badalona
Badalona, Barcelona, Spain
Hospital del Mar
Barcelona, Barcelona, Spain
Hospital Santa Creu i Sant Pau
Barcelona, Barcelona, Spain
Hospital Valle de Hebron
Barcelona, Barcelona, Spain
ICO Bellvitge
Response rate obtained after R-CHOP regimen followed by consolidation therapy with Alemtuzumab, as second line therapy. Haematological and non haematological toxicity will be graded in accordance with the WHO system
Time frame: 57 months
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L'Hospitalet de Llobregat, Barcelona, Spain
Althaia
Manresa, Barcelona, Spain
Corporacion Sanitaria Parc Tauli
Sabadell, Barcelona, Spain
Hospital de Basurto
Bilbao, Bilbao, Spain
Hospital Marques de Valdecilla
Santander, Cantabria, Spain
...and 22 more locations