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Low dose alemtuzumab in patients with fludarabine-refractory chronic lymphocytic leukemia.

Abstract
Alemtuzumab has been shown to be effective in poor-prognosis chronic lymphocytic leukemia (CLL); treatment, however, has been associated with significant toxicity. With the aim of seeking better tolerability, we treated 39 patients with fludarabine-refractory CLL subcutaneous alemtuzumab 10 mg three times a week, for 18 weeks. In 18 randomly selected patients, after obtaining lymphocyte count reduction by 1 Log, the antibody was administered once weekly at the dose of 30 mg. Overall response rate was 44%, including 8% complete remissions. Median overall survival and progression free survival were 29.1 and 10.3 months, respectively. Treatment was well tolerated, severe non-CMV infection occurred in 7% of the patients. CMV reactivation was detected in 27% of the patients, with only one case of CMV disease. No deaths occurred during therapy. In conclusion, low-dose alemtuzumab shows a promising safety profile coupled with satisfactory effectiveness in this category of poor prognosis CLL patients.
AuthorsGiuseppe Gritti, Gianluigi Reda, Francesco Maura, Alfonso Piciocchi, Luca Baldini, Stefano Molica, Antonino Neri, Agostino Cortelezzi
JournalLeukemia & lymphoma (Leuk Lymphoma) Vol. 53 Issue 3 Pg. 424-9 (Mar 2012) ISSN: 1029-2403 [Electronic] United States
PMID21919823 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Monoclonal, Murine-Derived
  • Antineoplastic Agents
  • Chlorambucil
  • Alemtuzumab
  • Rituximab
  • Cyclophosphamide
  • Vidarabine
  • fludarabine
Topics
  • Aged
  • Aged, 80 and over
  • Alemtuzumab
  • Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects, therapeutic use)
  • Antibodies, Monoclonal, Murine-Derived (administration & dosage)
  • Antineoplastic Agents (administration & dosage, adverse effects, therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Chlorambucil (administration & dosage)
  • Cyclophosphamide (administration & dosage)
  • Cytomegalovirus (physiology)
  • Cytomegalovirus Infections (etiology)
  • Dose-Response Relationship, Immunologic
  • Drug Administration Schedule
  • Drug Resistance, Neoplasm
  • Female
  • Follow-Up Studies
  • Hematologic Diseases (chemically induced)
  • Humans
  • Infusions, Intravenous
  • Injections, Subcutaneous
  • Kaplan-Meier Estimate
  • Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy)
  • Male
  • Middle Aged
  • Rituximab
  • Salvage Therapy
  • Vidarabine (administration & dosage, analogs & derivatives, pharmacology)
  • Virus Activation

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