Experience with alemtuzumab plus rituximab in patients with relapsed and refractory lymphoid malignancies.
We explored the safety and efficacy of rituximab plus alemtuzumab in patients with relapsed or refractory lymphoid malignancies. Forty-eight patients were treated and were assessable for response (32 with chronic lymphocytic leukemia [CLL], 9 with CLL/prolymphocytic leukemia [PLL], 1 with PLL, 4 with mantle cell leukemia/lymphoma, 2 with Richter transformation). The overall response rate was 52% (complete remission, 8%; nodular partial response, 4%; partial response, 40%). With a median follow-up of 6.5 months (range, 1-20 months), the median time to progression was 6 months (range, 1-20 months); median survival, 11 months (11+ months for responders vs 6 months for nonresponders). Most toxicities were grade 2 or lower and infusion-related. Infections occurred in 52% of the patients. Cytomegalovirus (CMV) antigenemia assays were positive in 27% of the patients, but only 15% were symptomatic and required therapy. The combination of rituximab and alemtuzumab is feasible, has an acceptable safety profile, and has clinical activity with a short course in a group of patients with poor prognoses.
Faderl
Stefan
S
Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA. sfaderl@mdanderson.org
Thomas
Deborah A
DA
O'Brien
Susan
S
Garcia-Manero
Guillermo
G
Kantarjian
Hagop M
HM
Giles
Francis J
FJ
Koller
Charles
C
Ferrajoli
Alessandra
A
Verstovsek
Srdan
S
Pro
Barbara
B
Andreeff
Michael
M
Beran
Miloslav
M
Cortes
Jorge
J
Wierda
William
W
Tran
Ngoc
N
Keating
Michael J
MJ
D000328:Adult; D000368:Aged; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology; D015703:Antigens, CD / Q000276:immunology; D018951:Antigens, CD20 / Q000276:immunology; D000951:Antigens, Neoplasm / Q000276:immunology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D000074301:CD52 Antigen; D003586:Cytomegalovirus Infections / Q000453:epidemiology; D018450:Disease Progression; D005240:Feasibility Studies; D005260:Female; D006023:Glycoproteins / Q000276:immunology; D006801:Humans; D007116:Immunization, Passive; D007239:Infections / Q000453:epidemiology; D008223:Lymphoma / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D012008:Recurrence; D012074:Remission Induction; D000069283:Rituximab; D012449:Safety; D016879:Salvage Therapy; D016019:Survival Analysis; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D058846:Antibodies, Monoclonal, Murine-Derived; D000912:Antibodies, Neoplasm; D015703:Antigens, CD; D018951:Antigens, CD20; D000951:Antigens, Neoplasm; D000074301:CD52 Antigen; C000613862:CD52 protein, human; D006023:Glycoproteins; D000074323:Alemtuzumab; D000069283:Rituximab