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Alert Number 102

Rituxan plus Leukine (GM-CSF) Has Benefit in NHL

Date: June 21, 2005

The combination of Rituxan with growth factors such as G-CSF (granulocyte colony stimulating factor - brand names Neupogen, Neulasta) and the broader-spectrum GM-CSF (granulocyte-macrophage colony stimulating factor - brand name Leukine) have been discussed frequently on this site. In fact, the combination of Rituxan + Neupogen or Neulasta, plus EGCG from green tea has been the basis of the "RHK protocol" designed by our hypothetical patient and Round Headed Kid, Harvey. Just yesterday we were bemoaning the fact that M. D. Anderson and some of the other CLL Consortium centers have put patients through Rituxan + Leukine (GM-CSF), but the results are yet to be published.

Hot off the news wires is this press release by Dr. Peter McLaughlin, lead investigator at M. D. Anderson, Lymphoma department. Not quite like hearing from our experts in the CLL arena, but since non-Hodgkin’s Lymphoma is a close kissing cousin of CLL, I thought you would find the news interesting.

This press release is based on a presentation made at the 9th international conference on lymphoma, in Lugano, Switzerland. (It is a tough life, traveling all the way to Lugano, Switzerland at the height of summer, but someone has to do this stuff, right?) The news is encouraging: 39 patients with mixed-bag NHL participated and the overall response rate was 79%, with 36% complete responses.

But do remember, this is NHL and not CLL. NHL patients tend to respond better to Rituxan than CLL patients, so I am inclined not to jump for joy with these statistics. Nevertheless, it is encouraging news that addition of a growth factor such as GM-CSF saw improved response in this B-cell lymphoma. I have to admit, the latest review we published on our website of the unexpectedly high adverse effects in combining Campath + G-CSF had me spooked. Scary stuff, especially since it was unexpected. But Rituxan is much more targeted than Campath, and therein lies the difference.

Now if only we can get our hand on the results of the clinical trial that combined Rituxan + Leukine in CLL patients, preferably as a full article in peer reviewed journal …

Be well,


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