The evolving role of alemtuzumab in management of patients with cll

feature-image

Play all audios:

Loading...

ABSTRACT New insights into prognostic markers and the pathophysiology of chronic lymphocytic leukemia (CLL) are beginning to change the concept of CLL treatment. Alemtuzumab has evolved as a


potent and effective therapeutic option for patients with CLL. Specifically, alemtuzumab has demonstrated substantial efficacy in fludarabine-refractory patients and has shown impressive


responses when administered subcutaneously in first-line therapy. A group of experts gathered to discuss new data related to the use of alemtuzumab in CLL and to assess its place in the


rapidly changing approach to treating patients with this disease. The main goals of this program were to update the management guidelines that were previously developed for


alemtuzumab-treated patients and to provide community oncologists with guidance on the most effective way to integrate alemtuzumab into a CLL treatment plan. Access through your institution


Buy or subscribe This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and


online access $259.00 per year only $21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes


which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Mavromatis B,


Cheson BD . Monoclonal antibody therapy of chronic lymphocytic leukemia. _J Clin Oncol_ 2003; 21: 1874–1881. Article  CAS  Google Scholar  * Countouriotis A, Moore TB, Sakamoto KM . Cell


surface antigen and molecular targeting in the treatment of hematologic malignancies. _Stem Cells_ 2002; 20: 215–229. Article  CAS  Google Scholar  * Hale G . CD52 (Campath-1). _J Biol Regul


Homeost Agents_ 2001; 15: 386–391. CAS  PubMed  Google Scholar  * Hale G . The CD52 antigen and development of the Campath antibodies. _Cytotherapy_ 2001; 3: 137–143. Article  CAS  Google


Scholar  * Keating MJ, Flinn I, Jain V, Binet J-L, Hillmen P, Byrd J et al. Therapeutic role of alemtuzumab (Campath-1H) in patients who have failed fludarabine: results of a large


international study. _Blood_ 2002; 99: 3554–3561. Article  CAS  Google Scholar  * Cheson BD, Bennett JM, Grever M, Kay N, Keating MJ, O'Brien S et al. National Cancer


Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment. _Blood_ 1996; 87: 4990–4997. CAS  PubMed  Google Scholar  *


Ferrajoli A, O'Brien SM, Cortes JE, Giles FJ, Thomas DA, Faderl S et al. Phase II study of alemtuzumab in chronic lymphoproliferative disorders. _Cancer_ 2003; 98: 773–778. Article  CAS


  Google Scholar  * Lozanski G, Heerema NA, Flinn IW, Smith L, Harbison J, Webb J et al. Alemtuzumab is an effective therapy for chronic lymphocytic leukemia with p53 mutations and


deletions. _Blood_ 2004; 103: 3278–3281. Article  CAS  Google Scholar  * Döhner H, Fischer K, Bentz M, Hansen K, Benner A, Cabot G et al. p53 gene deletion predicts for poor survival and


non-response to therapy with purine analogs in chronic B-cell leukemias. _Blood_ 1995; 85: 1580–1589. PubMed  Google Scholar  * Lundin J, Kimby E, Björkholm M, Bröliden P-A, Celsing F,


Hjalmar V et al. Phase II trial of subcutaneous anti-CD52 monoclonal antibody alemtuzumab (Campath-1 H) as first-line treatment for patients with B-cell chronic lymphocytic leukemia. _Blood_


2002; 100: 768–773. Article  CAS  Google Scholar  * Österborg A, Fassas AS, Anagnostopoulos A, Dyer MJ, Catovsky D, Mellstedt H . Humanized CD52 monoclonal antibody Campath-1 H as


first-line treatment in chronic lymphocytic leukaemia. _Br J Haematol_ 1996; 93: 151–153. Article  Google Scholar  * Hale G, Rebello P, Brettman LR, Fegan C, Kennedy B, Kimby E et al. Blood


concentrations of alemtuzumab and antiglobulin responses in patients with chronic lymphocytic leukemia following intravenous or subcutaneous routes of administration. _Blood_ 2004; 104:


948–955. Article  CAS  Google Scholar  * O'Brien SM, Kantarjian HM, Thomas DA, Cortes J, Giles FJ, Weirda WG et al. Alemtuzumab as treatment for residual disease after chemotherapy in


patients with chronic lymphocytic leukemia. _Cancer_ 2003; 98: 2657–2663. Article  CAS  Google Scholar  * Montillo M, Cafro AM, Tedeschi A, Brando B, Oreste P, Veronese S et al. Safety and


efficacy of subcutaneous Campath-1 H for treating residual disease in patients with chronic lymphocytic leukemia responding to fludarabine. _Haematologica_ 2002; 87: 695–700. CAS  PubMed 


Google Scholar  * Wendtner C-M, Ritgen M, Schweighofer CD, Fingerle-Rowson G, Campe H, Jäger G et al. Consolidation with alemtuzumab in patients with chronic lymphocytic leukemia (CLL) in


first remission – experience on safety and efficacy within a randomized multicenter phase III trial of the German CLL study group (GCLLSG). _Leukemia_ 2004; 18: 1093–1101. Article  CAS 


Google Scholar  * Byrd JC, Lucas MS, Farag S, Lin T . Old and new therapies of chronic lymphocytic leukemia: application to the patient. In: Perry M (ed). _ASCO Educational Book_.


Alexandria, VA: American Society of Clincial Oncology, 2003, pp 94–104. Google Scholar  * Kennedy B, Rawstron A, Carter C, Ryan M, Speed K, Lucase G et al. Campath-1H and fludarabine in


combination are highly active in refractory chronic lymphocytic leukemia. _Blood_ 2002; 99: 2245–2247. Article  CAS  Google Scholar  * Faderl S, Thomas DA, O'Brien S, Garcia-Manero G,


Kantarjian HM, Giles FJ et al. Experience with alemtuzumab plus rituximab in patients with relapsed and refractory lymphoid malignancies. _Blood_ 2003; 101: 3413–3415. Article  CAS  Google


Scholar  * Itälä M, Geisler CH, Kimby E, Juvonen E, Tjonnfjord G, Karlsson K et al. Standard-dose anti-CD20 antibody rituximab has efficacy in chronic lymphocytic leukaemia: results from a


Nordic multicentre study. _Eur J Haematol_ 2002; 69: 129–134. Article  Google Scholar  * Thieblemont C, Bouafia F, Hornez E, Dumontet C, Tartas S, Antal D et al. Maintenance therapy with a


monthly injection of alemtuzumab prolongs response duration in patients with refractory B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (B-CLL/SLL). _Leuk Lymphoma_ 2004; 45:


711–714. Article  CAS  Google Scholar  * Rai KR, Freter CE, Mercier RJ, Cooper MR, Mitchell BS, Stadtmauer EA et al. Alemtuzumab in previously treated chronic lymphocytic leukemia patients


who also had received fludarabine. _J Clin Oncol_ 2002; 20: 3891–3897. Article  CAS  Google Scholar  * Keating MJ, O'Brien S, Kontoyiannis D, Plunkett W, Koller C, Beran M et al.


Results of first salvage therapy for patients refractory to a fludarabine regimen in chronic lymphocytic leukemia. _Leuk Lymphoma_ 2002; 43: 1755–1762. Article  CAS  Google Scholar  *


Perkins JG, Flynn JM, Howard RS, Byrd JC . Frequency and type of serious infections in fludarabine-refractory B-cell chronic lymphocytic leukemia and small lymphocytic lymphoma. _Cancer_


2002; 94: 2033–2039. Article  Google Scholar  * Keating M, Coutre S, Rai K, sterborg A, Faderl S, Kennedy B et al. Management guidelines for use of alemtuzumab in B-cell chronic lymphocytic


leukemia. _Clin Lymphoma_ 2004; 4: 220–227. Article  CAS  Google Scholar  Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * The University of Texas M. D. Anderson Cancer


Center, Houston, TX, USA S Faderl & M Keating * Stanford University School of Medicine, Stanford, CA, USA S Coutré * The Arthur James Comprehensive Cancer Center, Columbus, OH, USA J C


Byrd * The Royal Marsden Hospital, Surrey, UK C Dearden * Washington University, Barnes-Jewish Hospital, St Louis, MO, USA A Denes * MRC Toxicology Unit, Leicester University, Leicester, UK


M J S Dyer * Rush University, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA S A Gregory & P Venugopal * Cancer Research UK, Medical Oncology Unit, Barts and the


London, Queen Mary's School of Medicine, University of London, London, UK J G Gribben * Pinderfields General Hospital, Wakefield, UK P Hillmen * Robert H. Lurie Comprehensive Cancer


Center, Chicago, IL, USA S Rosen * Long Island Jewish Medical Center, New Hyde Park, NY, USA K Rai Authors * S Faderl View author publications You can also search for this author inPubMed 


Google Scholar * S Coutré View author publications You can also search for this author inPubMed Google Scholar * J C Byrd View author publications You can also search for this author


inPubMed Google Scholar * C Dearden View author publications You can also search for this author inPubMed Google Scholar * A Denes View author publications You can also search for this


author inPubMed Google Scholar * M J S Dyer View author publications You can also search for this author inPubMed Google Scholar * S A Gregory View author publications You can also search


for this author inPubMed Google Scholar * J G Gribben View author publications You can also search for this author inPubMed Google Scholar * P Hillmen View author publications You can also


search for this author inPubMed Google Scholar * M Keating View author publications You can also search for this author inPubMed Google Scholar * S Rosen View author publications You can


also search for this author inPubMed Google Scholar * P Venugopal View author publications You can also search for this author inPubMed Google Scholar * K Rai View author publications You


can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to S Faderl. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE


Faderl, S., Coutré, S., Byrd, J. _et al._ The evolving role of Alemtuzumab in management of patients with CLL. _Leukemia_ 19, 2147–2152 (2005). https://doi.org/10.1038/sj.leu.2403984


Download citation * Received: 13 January 2005 * Accepted: 24 May 2005 * Published: 20 October 2005 * Issue Date: December 2005 * DOI: https://doi.org/10.1038/sj.leu.2403984 SHARE THIS


ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard


Provided by the Springer Nature SharedIt content-sharing initiative KEYWORDS * Alemtuzumab * CLL therapy * treatment guidelines * minimal residual disease * patient management