title: Experience with alemtuzumab plus rituximab in patients with relapsed and refractory lymphoid malignancies.
abstract: 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.
authors.affiliation: Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, 77030, USA. sfaderl@mdanderson.org
authors.forename: Stefan
authors.initials: S
authors.lastname: Faderl
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Thomas
authors.forename: Susan
authors.initials: S
authors.lastname: O'Brien
authors.forename: Guillermo
authors.initials: G
authors.lastname: Garcia-Manero
authors.forename: Hagop M
authors.initials: HM
authors.lastname: Kantarjian
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Giles
authors.forename: Charles
authors.initials: C
authors.lastname: Koller
authors.forename: Alessandra
authors.initials: A
authors.lastname: Ferrajoli
authors.forename: Srdan
authors.initials: S
authors.lastname: Verstovsek
authors.forename: Barbara
authors.initials: B
authors.lastname: Pro
authors.forename: Michael
authors.initials: M
authors.lastname: Andreeff
authors.forename: Miloslav
authors.initials: M
authors.lastname: Beran
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: William
authors.initials: W
authors.lastname: Wierda
authors.forename: Ngoc
authors.initials: N
authors.lastname: Tran
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Keating
mesh_terms: 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
chemical_list: 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