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Impact of Alemtuzumab Therapy and Route of Administration in T-Prolymphocytic Leukemia: A Single-Center Experience.

AbstractOBJECTIVE:
We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL).
PATIENTS AND METHODS:
The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014.
RESULTS:
A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56%) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78%) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P = .0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P = .0014). Only 4 (14%) of 28 patients aged < 70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months.
CONCLUSION:
In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.
AuthorsMoussab Damlaj, Nanna H Sulai, Jennifer L Oliveira, Rhett P Ketterling, Shahrukh Hashmi, Thomas Witzig, Grzegorz Nowakowski, Timothy G Call, Tait D Shanafelt, Wei Ding, William J Hogan, Mark R Litzow, Mrinal M Patnaik
JournalClinical lymphoma, myeloma & leukemia (Clin Lymphoma Myeloma Leuk) Vol. 15 Issue 11 Pg. 699-704 (Nov 2015) ISSN: 2152-2669 [Electronic] United States
PMID26422251 (Publication Type: Journal Article)
CopyrightCopyright © 2015 Elsevier Inc. All rights reserved.
Chemical References
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Alemtuzumab
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Alemtuzumab
  • Antibodies, Monoclonal, Humanized (administration & dosage, therapeutic use)
  • Antineoplastic Agents (administration & dosage, therapeutic use)
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Chromosome Aberrations
  • Drug Administration Routes
  • Female
  • Follow-Up Studies
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Induction Chemotherapy
  • Leukemia, Prolymphocytic, T-Cell (diagnosis, drug therapy, mortality, therapy)
  • Male
  • Middle Aged
  • Retrospective Studies
  • Salvage Therapy
  • Treatment Outcome

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