Intensified alemtuzumab-CHOP therapy for peripheral T-cell lymphoma.

Abstract

BACKGROUND:

The prognosis of T-cell lymphoma is poor. To explore the addition of the monoclonal antibody alemtuzumab, we studied the efficacy and tolerability of an intensified alemtuzumab-chemotherapy combination for aggressive T-cell lymphoma in a phase II study by Dutch-Belgian Hemato-Oncology Group (HOVON).

PATIENTS AND METHODS:

Patients (≤65 years) with newly diagnosed T-cell lymphoma received eight CHOP cycles (cyclophosphamide, doxorubicin, vincristine, prednisone) 2-weekly, each cycle with three doses of 30 mg alemtuzumab. Prophylaxis consisted of cotrimoxazole, fluconazole and valaciclovir. Cytomegalovirus (CMV) monitoring took place at least every fortnight.

RESULTS:

Twenty patients from 10 centers, median age 50 years, were included. Eighty-five percent received six or more cycles. The overall response was 90% [12 complete remissions (CRs), 1 CR unconfirmed, 5 partial remissions]. Median duration of follow-up of patients still alive was 29 months (range 19-41 months). Median overall survival (OS) and event-free survival (EFS) were 27 and 10 months, with 55%/27% OS/EFS at 2 years. Adverse events consisted of neutropenic fever (n = 8) and CMV reactivation (n = 7), with one CMV disease. Three patients developed secondary Epstein-Barr virus (EBV)-related lymphoma, all after end of treatment.

CONCLUSIONS:

Although intensified alemtuzumab-CHOP induces high responses, many patients relapse, and the scheme is associated with serious infection-related adverse events. EBV monitoring after end of treatment is required.

• Authors: H C Kluin-Nelemans, M van Marwijk Kooy, P J Lugtenburg, W L J van Putten, M Luten, J Oudejans, G W van Imhoff
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 22 Issue 7 Pg. 1595-1600 (Jul 2011) ISSN: 1569-8041 [Electronic] England
• PMID: 21212158 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Antibodies, Neoplasm
• Alemtuzumab
• Vincristine
• Doxorubicin
• Cyclophosphamide
• Prednisone

Topics

• Adolescent
• Adult
• Aged
• Alemtuzumab
• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Humanized
• Antibodies, Neoplasm (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cyclophosphamide (administration & dosage)
• Doxorubicin (administration & dosage)
• Female
• Follow-Up Studies
• Humans
• Lymphoma, T-Cell, Peripheral (drug therapy, pathology)
• Male
• Middle Aged
• Prednisone (administration & dosage)
• Survival Rate
• Treatment Outcome
• Vincristine (administration & dosage)
• Young Adult