Clinical outcome of pretreated B-cell chronic lymphocytic leukemia following alemtuzumab therapy: a retrospective study on various cytogenetic risk categories.
BACKGROUND
Patients with B-cell chronic lymphocytic leukemia (CLL) with 17p deletion respond poorly to chemotherapy. This retrospective study evaluated the benefit of alemtuzumab monotherapy in unselected patients with advanced CLL in the various cytogenetic subgroups.


METHODS
Data were collected from 105 consecutive, pretreated, cytogenetically defined patients who had received alemtuzumab. Response, progression-free survival (PFS), and overall survival (OS) were assessed.


RESULTS
The hierarchic incidence of cytogenetic abnormalities was: 13q deletion (as sole abnormality), 18%; trisomy 12, 13%; 11q deletion, 19%; 17p deletion, 33%; and none of these, 16%. Overall response rate (ORR) was 43% in the total cohort and 49% in the subgroup of 17p-deleted patients (n = 35). From the start of alemtuzumab monotherapy, median PFS in the total cohort and in the subgroup of 17p-deleted patients was 7.0 and 7.1 months, respectively. Median OS in the total cohort and in 17p-deleted patients was 32.8 and 19.1 months, respectively. The poor-risk group of patients with CLL (i.e. fludarabine resistant, 17p deletion; n = 20) showed encouraging ORR, PFS, and OS (35%, 7.0 and 19.2 months, respectively).


CONCLUSIONS
Alemtuzumab was effective in treating patients with CLL across the cytogenetic categories evaluated, but there were differences. In patients with CLL with 17p deletion quite favorable ORR, PFS, and OS were achieved.
Fiegl
M
M
Division of Hematology and Oncology, Department of Internal Medicine V. Electronic address: michael.fiegl@i-med.ac.at.
Erdel
M
M
Department of Medical Genetics, Medical University of Innsbruck, Innsbruck.
Tinhofer
I
I
Department of Internal Medicine III, Private Medical University of Salzburg, Salzburg, Austria.
Brychtova
Y
Y
Department of Internal Medicine-Hematooncology, Medical Faculty of Masaryk University, Brno, Czech Republic.
Panovska
A
A
Department of Internal Medicine-Hematooncology, Medical Faculty of Masaryk University, Brno, Czech Republic.
Doubek
M
M
Department of Internal Medicine-Hematooncology, Medical Faculty of Masaryk University, Brno, Czech Republic.
Eigenberger
K
K
Division of Hematology and Hemostaseology, Department of Internal Medicine I.
Fonatsch
C
C
Department of Medical Genetics, Medical University of Vienna.
Hopfinger
G
G
Department of Internal Medicine III, Hanuschspital, Vienna.
Mühlberger
H
H
Department of Internal Medicine III, Hanuschspital, Vienna.
Zabernigg
A
A
Department of Internal Medicine, Hospital of Kufstein, Kufstein, Austria.
Falkner
F
F
Division of Hematology and Oncology, Department of Internal Medicine V.
Gastl
G
G
Division of Hematology and Oncology, Department of Internal Medicine V.
Mayer
J
J
Department of Internal Medicine-Hematooncology, Medical Faculty of Masaryk University, Brno, Czech Republic.
Greil
R
R
Department of Internal Medicine III, Private Medical University of Salzburg, Salzburg, Austria.
D000368:Aged; D000369:Aged, 80 and over; 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 / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002869:Chromosome Aberrations / Q000706:statistics & numerical data; D018450:Disease Progression; D064420:Drug-Related Side Effects and Adverse Reactions / Q000235:genetics; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000235:genetics* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000912:Antibodies, Neoplasm; D000970:Antineoplastic Agents; D000074323:Alemtuzumab