title: Impact of Alemtuzumab Therapy and Route of Administration in T-Prolymphocytic Leukemia: A Single-Center Experience.
abstract: OBJECTIVE
  We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL).
  
  
  METHODS
  The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014.
  
  
  RESULTS
  A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56%) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78%) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P = .0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P = .0014). Only 4 (14%) of 28 patients aged < 70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months.
  
  
  CONCLUSIONS
  In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN. Electronic address: moussab.damlaj@mail.mcgill.ca.
authors.forename: Moussab
authors.initials: M
authors.lastname: Damlaj
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Nanna H
authors.initials: NH
authors.lastname: Sulai
authors.affiliation: Division of Hematopathology, Department of Laboratory Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Oliveira
authors.affiliation: Division of Hematopathology, Department of Laboratory Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Rhett P
authors.initials: RP
authors.lastname: Ketterling
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Shahrukh
authors.initials: S
authors.lastname: Hashmi
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Thomas
authors.initials: T
authors.lastname: Witzig
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Nowakowski
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Call
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Tait D
authors.initials: TD
authors.lastname: Shanafelt
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Wei
authors.initials: W
authors.lastname: Ding
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hogan
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Litzow
authors.affiliation: Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
authors.forename: Mrinal M
authors.initials: MM
authors.lastname: Patnaik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000074323:Alemtuzumab; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002869:Chromosome Aberrations; D004333:Drug Administration Routes; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D060828:Induction Chemotherapy; D015461:Leukemia, Prolymphocytic, T-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000074323:Alemtuzumab
keywords: Alemtuzumab; GVHD; HSCT; T-PLL