Alemtuzumab maintenance may safely prolong chemotherapy-free intervals in chronic lymphocytic leukemia.

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Alemtuzumab maintenance may safely prolong chemotherapy-free intervals in

chronic lymphocytic leukemia.

MS Kaufman, A Caramanica, D Janson, N Driscoll, C , N Kohn, T Wasil, and

KR Rai

Med Oncol, March 17, 2010;

Department of Medicine, Division of Hematology and Oncology, Long Island Jewish

Medical Center, CLL Research and Treatment Center, New Hyde Park, NY, USA,

mkaufman@....

This prospective, single-arm study utilized alemtuzumab as a single agent in a

novel maintenance schedule in previously treated chronic lymphocytic leukemia

patients with the goal of delaying progression of disease and requirement for

chemotherapy. In previously treated CLL patients who had achieved stable disease

or better, the following schedule of subcutaneous alemtuzumab was administered:

a dose escalation in the first week (3, 10 and 30 mg), followed by 7 weeks of 30

mg alemtuzumab once weekly, 16 weeks of 30 mg once every 2 weeks, followed by

once every 3 weeks for 24 weeks. Thus, the entire duration of the planned

treatment was 48 weeks. A total of 12 patients were enrolled 11 of which had at

least one marker of poor prognosis (unmutated, Zap 70+, CD38+, del11q and

del17p). The median chemotherapy-free interval was 13 months, and the median

time to disease progression was 10 months. Three patients achieved a CR, one

achieved nPR, one had a PR, five failed and two had shown a beneficial response

but because of recurrent ITP had to stop alemtuzumab. In six of the 10 patients

with previously relapsed disease, the chemotherapy-free interval was longer than

their prior chemotherapy-free period. One patient had a reactivation of CMV

antigenemia, and another had a bacterial pneumonia. There were no grade 3 or 4

toxicities. Alemtuzumab used in a maintenance schedule is a potentially safe and

useful tool in delaying disease progression and chemotherapy-free intervals in

previously treated CLL patients.

PMID: 20237867

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