Sustained hematologic and central nervous system remission with single-agent denileukin diftitox in refractory adult T-cell leukemia/lymphoma.
Human T-lymphotrophic virus-1-associated adult T-cell leukemia/lymphoma (ATLL) is a rare and often fatal disease. Initial treatment often includes zidovudine/interferon (IFN)-based therapy, although disease remission is typically not complete or durable. This study reports on a 55-year-old man with relapsed/refractory leukemic-phase ATLL including significant central nervous system (CNS) disease with resistance to previous zidovudine/IFN and arsenic trioxide/IFN treatment. The patient experienced a rapid hematologic and CNS clinical response with single-agent denileukin diftitox therapy (18 microg/kg per day for 5 days). He tolerated 8 cycles of denileukin diftitox therapy well and experienced a sustained complete hematologic and CNS remission. The patient subsequently underwent matched sibling reduced-intensity allogeneic transplantation and remains disease free. Further study examining denileukin diftitox in patients with relapsed/refractory ATLL is warranted.
Evens
Andrew M
AM
Division of Hematology/Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Chicago, IL 60611, USA. a-evens@northwestern.edu
Ziegler
Sheryl L
SL
Gupta
Rohit
R
Augustyniak
Connie
C
Gordon
Leo I
LI
Mehta
Jayesh
J
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D000077237:Arsenic Trioxide; D001152:Arsenicals / Q000008:administration & dosage; D016026:Bone Marrow Transplantation; D016543:Central Nervous System Neoplasms / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D004167:Diphtheria Toxin / Q000008:administration & dosage*; D019008:Drug Resistance, Neoplasm / Q000187:drug effects; D019337:Hematologic Neoplasms / Q000473:pathology / Q000628:therapy*; D006801:Humans; D007372:Interferons / Q000008:administration & dosage; D007376:Interleukin-2 / Q000008:administration & dosage*; D015459:Leukemia-Lymphoma, Adult T-Cell / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000008:administration & dosage; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage; D012008:Recurrence; D012074:Remission Induction; D014184:Transplantation, Homologous; D015215:Zidovudine / Q000008:administration & dosage
D001152:Arsenicals; D004167:Diphtheria Toxin; D007376:Interleukin-2; D010087:Oxides; D011993:Recombinant Fusion Proteins; C078456:denileukin diftitox; D015215:Zidovudine; D007372:Interferons; D000077237:Arsenic Trioxide