title: Campath-1H and fludarabine in combination are highly active in refractory chronic lymphocytic leukemia.
abstract: Campath-1H (alemtuzumab) is the most effective monoclonal antibody in single-agent use in B-cell chronic lymphocytic leukemia (CLL) with reported response rates of 33% to 70%. Combination therapy is now the conventional treatment for most hematologic malignancies. Monoclonal antibody treatments may sensitize tumor cells to subsequent chemotherapy. We report the combination of Campath-1H with fludarabine in patients with CLL refractory to each agent used singly. Six patients who had received a median of 8 courses of fludarabine (range, 4-10 courses) and 16 weeks of Campath-1H (range, 8-32 weeks) were treated. Five patients responded, including one who had a complete response by National Cancer Institute criteria. The responses observed were better in each patient than responses after each agent used singly. Complete morphologic bone marrow responses were seen in 3 patients, including eradication of disease measured by sensitive flow cytometry in 2. Campath-1H combined with fludarabine is a highly promising novel therapy for refractory CLL.
authors.affiliation: Haematological Malignancy Diagnostic Service, Institute of Pathology, Algernon Firth Building, University of Leeds, Leeds LS2 9JT, West Yorkshire, UK. medbk@leeds.ac.uk
authors.forename: Ben
authors.initials: B
authors.lastname: Kennedy
authors.forename: Andy
authors.initials: A
authors.lastname: Rawstron
authors.forename: Chris
authors.initials: C
authors.lastname: Carter
authors.forename: Mary
authors.initials: M
authors.lastname: Ryan
authors.forename: Kevin
authors.initials: K
authors.lastname: Speed
authors.forename: Guy
authors.initials: G
authors.lastname: Lucas
authors.forename: Peter
authors.initials: P
authors.lastname: Hillmen
mesh_terms: D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D001853:Bone Marrow / Q000473:pathology; D004351:Drug Resistance; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D013810:Therapeutic Equivalency; D016896:Treatment Outcome; D014740:Vidarabine / Q000008:administration & dosage* / Q000031:analogs & derivatives
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000074323:Alemtuzumab; D014740:Vidarabine; C024352:fludarabine