Flavopiridol inhibits cyclin-dependent kinases that may induce apoptosis. With a pharmacokinetically guided dose schedule of a 30-mg IV bolus, followed by a 30-50-mg 4 -hour infusion, 45% of patients with advanced CLL achieved a remission that lasted approximately 1 year.31 This regimen, however, is associated with significant toxicity, including a severe tumor lysis syndrome that excludes patients with a white blood cell count greater than 200/ ^L and mandates hospital-ization for aggressive hydration and prophylactic ras-buricase. The drug is also myelosuppressive, with 100% grade 3-4 neutropenia.

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