Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Leading Article
  • Published:

The evolving role of Alemtuzumab in management of patients with CLL

Leukemia volume 19, pages 2147–2152 (2005)Cite this article

Abstract

New insights into prognostic markers and the pathophysiology of chronic lymphocytic leukemia (CLL) are beginning to change the concept of CLL treatment. Alemtuzumab has evolved as a potent and effective therapeutic option for patients with CLL. Specifically, alemtuzumab has demonstrated substantial efficacy in fludarabine-refractory patients and has shown impressive responses when administered subcutaneously in first-line therapy. A group of experts gathered to discuss new data related to the use of alemtuzumab in CLL and to assess its place in the rapidly changing approach to treating patients with this disease. The main goals of this program were to update the management guidelines that were previously developed for alemtuzumab-treated patients and to provide community oncologists with guidance on the most effective way to integrate alemtuzumab into a CLL treatment plan.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

References

  1. Mavromatis B, Cheson BD . Monoclonal antibody therapy of chronic lymphocytic leukemia. J Clin Oncol 2003; 21: 1874–1881.

    Article  CAS  Google Scholar 

  2. Countouriotis A, Moore TB, Sakamoto KM . Cell surface antigen and molecular targeting in the treatment of hematologic malignancies. Stem Cells 2002; 20: 215–229.

    Article  CAS  Google Scholar 

  3. Hale G . CD52 (Campath-1). J Biol Regul Homeost Agents 2001; 15: 386–391.

    CAS  PubMed  Google Scholar 

  4. Hale G . The CD52 antigen and development of the Campath antibodies. Cytotherapy 2001; 3: 137–143.

    Article  CAS  Google Scholar 

  5. Keating MJ, Flinn I, Jain V, Binet J-L, Hillmen P, Byrd J et al. Therapeutic role of alemtuzumab (Campath-1H) in patients who have failed fludarabine: results of a large international study. Blood 2002; 99: 3554–3561.

    Article  CAS  Google Scholar 

  6. Cheson BD, Bennett JM, Grever M, Kay N, Keating MJ, O'Brien S et al. National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment. Blood 1996; 87: 4990–4997.

    CAS  PubMed  Google Scholar 

  7. Ferrajoli A, O'Brien SM, Cortes JE, Giles FJ, Thomas DA, Faderl S et al. Phase II study of alemtuzumab in chronic lymphoproliferative disorders. Cancer 2003; 98: 773–778.

    Article  CAS  Google Scholar 

  8. Lozanski G, Heerema NA, Flinn IW, Smith L, Harbison J, Webb J et al. Alemtuzumab is an effective therapy for chronic lymphocytic leukemia with p53 mutations and deletions. Blood 2004; 103: 3278–3281.

    Article  CAS  Google Scholar 

  9. Döhner H, Fischer K, Bentz M, Hansen K, Benner A, Cabot G et al. p53 gene deletion predicts for poor survival and non-response to therapy with purine analogs in chronic B-cell leukemias. Blood 1995; 85: 1580–1589.

    PubMed  Google Scholar 

  10. Lundin J, Kimby E, Björkholm M, Bröliden P-A, Celsing F, Hjalmar V et al. Phase II trial of subcutaneous anti-CD52 monoclonal antibody alemtuzumab (Campath-1 H) as first-line treatment for patients with B-cell chronic lymphocytic leukemia. Blood 2002; 100: 768–773.

    Article  CAS  Google Scholar 

  11. Österborg A, Fassas AS, Anagnostopoulos A, Dyer MJ, Catovsky D, Mellstedt H . Humanized CD52 monoclonal antibody Campath-1 H as first-line treatment in chronic lymphocytic leukaemia. Br J Haematol 1996; 93: 151–153.

    Article  Google Scholar 

  12. Hale G, Rebello P, Brettman LR, Fegan C, Kennedy B, Kimby E et al. Blood concentrations of alemtuzumab and antiglobulin responses in patients with chronic lymphocytic leukemia following intravenous or subcutaneous routes of administration. Blood 2004; 104: 948–955.

    Article  CAS  Google Scholar 

  13. O'Brien SM, Kantarjian HM, Thomas DA, Cortes J, Giles FJ, Weirda WG et al. Alemtuzumab as treatment for residual disease after chemotherapy in patients with chronic lymphocytic leukemia. Cancer 2003; 98: 2657–2663.

    Article  CAS  Google Scholar 

  14. Montillo M, Cafro AM, Tedeschi A, Brando B, Oreste P, Veronese S et al. Safety and efficacy of subcutaneous Campath-1 H for treating residual disease in patients with chronic lymphocytic leukemia responding to fludarabine. Haematologica 2002; 87: 695–700.

    CAS  PubMed  Google Scholar 

  15. Wendtner C-M, Ritgen M, Schweighofer CD, Fingerle-Rowson G, Campe H, Jäger G et al. Consolidation with alemtuzumab in patients with chronic lymphocytic leukemia (CLL) in first remission – experience on safety and efficacy within a randomized multicenter phase III trial of the German CLL study group (GCLLSG). Leukemia 2004; 18: 1093–1101.

    Article  CAS  Google Scholar 

  16. Byrd JC, Lucas MS, Farag S, Lin T . Old and new therapies of chronic lymphocytic leukemia: application to the patient. In: Perry M (ed). ASCO Educational Book. Alexandria, VA: American Society of Clincial Oncology, 2003, pp 94–104.

    Google Scholar 

  17. Kennedy B, Rawstron A, Carter C, Ryan M, Speed K, Lucase G et al. Campath-1H and fludarabine in combination are highly active in refractory chronic lymphocytic leukemia. Blood 2002; 99: 2245–2247.

    Article  CAS  Google Scholar 

  18. Faderl S, Thomas DA, O'Brien S, Garcia-Manero G, Kantarjian HM, Giles FJ et al. Experience with alemtuzumab plus rituximab in patients with relapsed and refractory lymphoid malignancies. Blood 2003; 101: 3413–3415.

    Article  CAS  Google Scholar 

  19. Itälä M, Geisler CH, Kimby E, Juvonen E, Tjonnfjord G, Karlsson K et al. Standard-dose anti-CD20 antibody rituximab has efficacy in chronic lymphocytic leukaemia: results from a Nordic multicentre study. Eur J Haematol 2002; 69: 129–134.

    Article  Google Scholar 

  20. Thieblemont C, Bouafia F, Hornez E, Dumontet C, Tartas S, Antal D et al. Maintenance therapy with a monthly injection of alemtuzumab prolongs response duration in patients with refractory B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma (B-CLL/SLL). Leuk Lymphoma 2004; 45: 711–714.

    Article  CAS  Google Scholar 

  21. Rai KR, Freter CE, Mercier RJ, Cooper MR, Mitchell BS, Stadtmauer EA et al. Alemtuzumab in previously treated chronic lymphocytic leukemia patients who also had received fludarabine. J Clin Oncol 2002; 20: 3891–3897.

    Article  CAS  Google Scholar 

  22. Keating MJ, O'Brien S, Kontoyiannis D, Plunkett W, Koller C, Beran M et al. Results of first salvage therapy for patients refractory to a fludarabine regimen in chronic lymphocytic leukemia. Leuk Lymphoma 2002; 43: 1755–1762.

    Article  CAS  Google Scholar 

  23. Perkins JG, Flynn JM, Howard RS, Byrd JC . Frequency and type of serious infections in fludarabine-refractory B-cell chronic lymphocytic leukemia and small lymphocytic lymphoma. Cancer 2002; 94: 2033–2039.

    Article  Google Scholar 

  24. Keating M, Coutre S, Rai K, sterborg A, Faderl S, Kennedy B et al. Management guidelines for use of alemtuzumab in B-cell chronic lymphocytic leukemia. Clin Lymphoma 2004; 4: 220–227.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA

    S Faderl & M Keating

  2. Stanford University School of Medicine, Stanford, CA, USA

    S Coutré

  3. The Arthur James Comprehensive Cancer Center, Columbus, OH, USA

    J C Byrd

  4. The Royal Marsden Hospital, Surrey, UK

    C Dearden

  5. Washington University, Barnes-Jewish Hospital, St Louis, MO, USA

    A Denes

  6. MRC Toxicology Unit, Leicester University, Leicester, UK

    M J S Dyer

  7. Rush University, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA

    S A Gregory & P Venugopal

  8. Cancer Research UK, Medical Oncology Unit, Barts and the London, Queen Mary's School of Medicine, University of London, London, UK

    J G Gribben

  9. Pinderfields General Hospital, Wakefield, UK

    P Hillmen

  10. Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA

    S Rosen

  11. Long Island Jewish Medical Center, New Hyde Park, NY, USA

    K Rai

Authors
  1. S Faderl
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Coutré
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J C Byrd
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Dearden
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. A Denes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M J S Dyer
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. S A Gregory
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. J G Gribben
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. P Hillmen
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. M Keating
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. S Rosen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. P Venugopal
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. K Rai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S Faderl.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Faderl, S., Coutré, S., Byrd, J. et al. The evolving role of Alemtuzumab in management of patients with CLL. Leukemia 19, 2147–2152 (2005). https://doi.org/10.1038/sj.leu.2403984

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.leu.2403984

Keywords

This article is cited by

Search

Advanced search

Quick links