Alemtuzumab for B-cell chronic lymphocytic leukemia.

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Alemtuzumab for B-cell chronic lymphocytic leukemia.

T Robak

Expert Rev Anticancer Ther, July 1, 2008; 8(7): 1033-51.

Department of Hematology, Medical University of Lodz, 93-510 Lodz, ul.

Ciolkowskiego 2, Poland. robaktad@...

Alemtuzumab (Campath, MabCampath) is a humanized therapeutic monoclonal antibody

(mAb) that recognizes the CD52 antigen expressed on normal and neoplastic

lymphoid cells. This mAb is active in previously treated patients with B-cell

chronic lymphocytic leukemia (B-CLL) refractory to alkylating agents and purine

nucleoside analogs. Alemtuzumab is also investigated in previously untreated

patients with this leukemia. The results of a prospective randomized Phase III

study (CAM307 trial) comparing chlorambucil with alemtuzumab in the first-line

treatment of progressive B-CLL were recently published. The overall response

rate, complete remission rate, and progression-free survival were all superior

for alemtuzumab. Moreover, elimination of minimal residual disease occurred in

one third of complete responders to alemtuzumab and none to chlorambucil.

Adverse events were similar in both arms with the exception of infusion-related

reactions and cytomegalovirus infections. In 2001, alemtuzumab was approved in

the USA and Europe as a third-line therapy for patients with B-CLL who had been

treated with alkylating agents and failed fludarabine therapy. In September

2007, the US FDA, on the basis of CAM307 results, approved alemtuzumab for the

treatment of previously untreated patients with B-CLL. Moreover, the European

Commission recently granted marketing authorization to alemtuzumab for the

treatment of patients with B-CLL for whom fludarabine combination monotherapy is

not appropriate.

PMID: 18588450