Clinical outcome of pretreated B-cell chronic lymphocytic leukemia following alemtuzumab therapy: a retrospective study on various cytogenetic risk categories

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BlankClinical outcome of pretreated B-cell chronic lymphocytic leukemia

following alemtuzumab therapy: a retrospective study on various cytogenetic risk

categories

1.. M. Fiegl1,*,

2.. M. Erdel2,

3.. I. Tinhofer3,

4.. Y. Brychtova4,

5.. A. Panovska4,

6.. M. Doubek4,

7.. K. Eigenberger5,

8.. C. Fonatsch6,

9.. G. Hopfinger7,

10.. H. Mühlberger7,

11.. A. Zabernigg8,

12.. F. Falkner1,

13.. G. Gastl1,

14.. J. Mayer4,

15.. R. Greil3 and

16.. for The Austrian Collaborative Study Group on Alemtuzumab in Chronic

Lymphocytic Leukemia, in cooperation with The Czech Leukemia Study Group for

Life, CELL

+ Author Affiliations

1.. 1Division of Hematology and Oncology, Department of Internal Medicine V

2.. 2Department of Medical Genetics, Medical University of Innsbruck,

Innsbruck

3.. 3Department of Internal Medicine III, Private Medical University of

Salzburg, Salzburg, Austria

4.. 4Department of Internal Medicine–Hematooncology, Medical Faculty of

Masaryk University, Brno, Czech Republic

5.. 5Division of Hematology and Hemostaseology, Department of Internal

Medicine I

6.. 6Department of Medical Genetics, Medical University of Vienna

7.. 7Department of Internal Medicine III, Hanuschspital, Vienna

8.. 8Department of Internal Medicine, Hospital of Kufstein, Kufstein, Austria

1.. *Correspondence to: Dr M. Fiegl, Division of Hematology and Oncology,

Department of Internal Medicine V, Medical University of Innsbruck, Anichstrasse

35, 6020 Innsbruck, Austria. Tel: +43-512-504-24003; Fax: +43-512-504-25615;

E-mail: michael.fiegl@...

a.. Received August 29, 2009.

b.. Revision received February 6, 2010.

c.. Accepted March 23, 2010.

Abstract

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.

Patients and 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.