Molecular Remission Using Low-Dose Immunotherapy with Minimal Toxicities for Poor Prognosis IGHV- Unmutated Chronic Lymphocytic Leukemia

Cells. 2020 Dec 22;10(1):10. doi: 10.3390/cells10010010.

Abstract

Chronic lymphocytic leukemia (CLL) accounts for 10% of hematologic malignancies. CLL is a malignancy of CD5+ B cells and it is characterized by the accumulation of small, mature-appearing neoplastic lymphocytes in the blood, bone marrow, and secondary lymphoid tissues. In the present case, a middle-aged female patient with poor prognosis unmutated IGHV CLL achieved cytogenetic and molecular remission with minimal adverse events following six cycles of low dose recombinant human IL-2 (rIL-2) in combination with low dose targeted venetoclax. Personalized low dose rIL-2 in combination with either lenalidomide or venetoclax mediates natural killer stimulation and is an effective non-toxic immunotherapy administered in the outpatient setting for poor prognosis CLL.

Keywords: cancer treatment; chronic lymphocytic leukemia; immunotherapy; interleukin-2; natural killer cells.

Publication types

  • Case Reports

MeSH terms

  • Adenine / adverse effects
  • Adenine / analogs & derivatives
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols
  • Bridged Bicyclo Compounds, Heterocyclic / administration & dosage*
  • Female
  • Humans
  • Immunologic Factors / administration & dosage*
  • Immunotherapy
  • Interleukin-2 / administration & dosage*
  • Killer Cells, Natural / cytology
  • Killer Cells, Natural / immunology
  • Lenalidomide / adverse effects
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy*
  • Middle Aged
  • Piperidines / adverse effects
  • Precision Medicine
  • Prognosis
  • Remission Induction
  • Sulfonamides / administration & dosage*

Substances

  • Antineoplastic Agents
  • Bridged Bicyclo Compounds, Heterocyclic
  • Immunologic Factors
  • Interleukin-2
  • Piperidines
  • Sulfonamides
  • ibrutinib
  • Lenalidomide
  • Adenine
  • venetoclax