title: Clinical activity of a new regimen combining gemcitabine and alemtuzumab in high-risk relapsed/refractory chronic lymphocytic leukemia patients.
abstract: Optimal treatment strategies are lacking in relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL). Gemcitabine has shown activity and acceptable safety profile in B-cell lymphomas. We present a retrospective case review of gemcitabine and alemtuzumab, every 21 d (for up to six courses) in 27 community-based patients with high-risk R/R CLL. Median age was 70 yr (44-83 yr), 55% patients had Binet stage C, deletion 17p (del(17p)) and/or deletion 11q (del(11q)) were found in 65% and 27%, bulky disease in 55.5%, and fludarabine-refractoriness in 48% of cases, respectively. Overall response rate was 63% (29.6% clinical CR and 33.4% PR). At a median follow-up of 31 months, median PFS and OS were 15.4 and 24 months. In multivariate analysis, median OS is influenced by prior lines of treatment = 3 and bulky disease. Combination of alemtuzumab and gemcitabine appears to be an active, easy to administrate treatment in routine practice, high-risk R/R CLL patients.
authors.affiliation: Department of Hematology, Purpan University Hospital, Toulouse cedex, France.
authors.forename: Lucie
authors.initials: L
authors.lastname: Oberic
authors.forename: Willy
authors.initials: W
authors.lastname: Vaillant
authors.forename: Benjamin
authors.initials: B
authors.lastname: Hebraud
authors.forename: Christian
authors.initials: C
authors.lastname: Recher
authors.forename: Etienne
authors.initials: E
authors.lastname: Suc
authors.forename: Philippe
authors.initials: P
authors.lastname: Houyau
authors.forename: Guy
authors.initials: G
authors.lastname: Laurent
authors.forename: Loic
authors.initials: L
authors.lastname: Ysebaert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012008:Recurrence; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D003841:Deoxycytidine; D000074323:Alemtuzumab; D000093542:Gemcitabine
keywords: alemtuzumab; chronic lymphocytic leukemia; fludarabine-refractory; gemcitabine