[Treatment of T-cell prolymphocytic leukemia with monoclonal anti- CD52 antibody (alemtuzumab].
BACKGROUND
T-cell prolymphocytic leukaemia (T-PLL) is a rare post-thymic T-cell malignancy with an aggressive clinical course. It has generally been resistant to alkylating chemotherapy, but some effect has been observed with the purine analog 2-deoxycoformicin with documented partial or complete response rates in up to 45% of patients. Treatment with monoclonal antibodies against CD 52 has been shown to be highly effective in T-PLL with response rates of up to 76%. This may allow for further consolidating treatment with high-dose chemotherapy with autologous stem cell support or allogeneic stem cell transplantation.


METHODS
Five patients treated at Rikshospitalet University Hospital are evaluated and the literature on T-PLL is reviewed.


CONCLUSIONS
Four of our patients were treated with alemtuzumab. Three showed complete or partial response. One patient underwent allogeneic stem cell transplantation with an HLA-identical sibling, but died on day 21 as a result of transplantation complications. The treatment is generally well tolerated; the principal management problem is immunosuppression, as shown in one patient who developed a varicella-zoster meningoencephalomyelitis as a consequence of not receiving antiviral prophylaxis. The main infusion-related adverse effects are fever and chills.
Fløisand
Yngvar
Y
Seksjon for blodsykdommer, Medisinsk avdeling, Rikshospitalet, 0027 Oslo. yngvar.floisand@rikshospitalet.no
Brinch
Lorentz
L
Gedde-Dahl
Tobias
T
Tjønnfjord
Geir E
GE
D000328:Adult; D000074323:Alemtuzumab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D015463:Leukemia, Prolymphocytic / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D015458:Leukemia, T-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011379:Prognosis
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D000074323:Alemtuzumab