Treatment of chronic lymphocytic leukemia with alemtuzumab: a review for nurses.
OBJECTIVE
To review the use of the monoclonal antibody alemtuzumab in patients with advanced refractory B cell chronic lymphocytic leukemia (B-CLL) and nursing management during treatment.


METHODS
Published articles, abstracts, book chapters, Web sites, and training material.


RESULTS
Alemtuzumab can achieve disease remission in patients with chemorefractory B-CLL; however, management of high-risk patients presents certain challenges. Infusion-related events can be minimized by stepwise administration and appropriate prophylaxis. Cytopenia can be minimized by drug postponement and cytokine support or red blood cell or platelet transfusions. Patients also are at risk for infection because of lymphopenia, and anti-infective prophylaxis is mandatory at initiation of therapy until at least two months post-treatment.


CONCLUSIONS
With satisfactory supportive measures in place, patients with chemorefractory B-CLL can experience the benefits of alemtuzumab therapy without excessive toxicity.


CONCLUSIONS
Nurses should be familiar with treatment and prophylactic protocols, be ready to offer supportive therapy to control side effects, and invest time in patient education.
Lynn
Alice
A
University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. Alynn@mail.mdanderson.org
Williams
Mary L
ML
Sickler
Jennifer
J
Burgess
Sandra
S
D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy* / Q000451:nursing*; D009859:Oncology Nursing / Q000193:education*; D009894:Opportunistic Infections / Q000451:nursing / Q000517:prevention & control
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D000074323:Alemtuzumab