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Phase II trial of subcutaneous anti-CD52 monoclonal antibody alemtuzumab (Campath-1H) as first-line treatment for patients with B-cell chronic lymphocytic leukemia (B-CLL).
Lundin, Jeanette; Kimby, Eva; Björkholm, Magnus; Broliden, Per-Anders; Celsing, Fredrik; Hjalmar, Viktoria; Möllgård, Lars; Rebello, Peppy; Hale, Geoff; Waldmann, Herman; Mellstedt, Håkan; Osterborg, Anders.
Afiliación
  • Lundin J; Department of Hematology, Karolinska Hospital, and Huddinge University Hospital, Stockholm, Sweden.
Blood ; 100(3): 768-73, 2002 Aug 01.
Article en En | MEDLINE | ID: mdl-12130484
This phase II study determined the efficacy and safety of alemtuzumab, a humanized anti-CD52 monoclonal antibody, delivered subcutaneously as first-line therapy, over a prolonged treatment period of 18 weeks in 41 patients with symptomatic B-cell chronic lymphocytic leukemia (B-CLL). Injections were administered subcutaneously 3 times per week, from week 2 to 3 onward. An overall response rate (OR) of 87% (95% CI, 76%-98%; complete remission [CR], 19%; partial remission [PR], 68%) was achieved in 38 evaluable patients (81% of intent-to-treat population). CLL cells were cleared from blood in 95% patients in a median time of 21 days. CR or nodular PR in the bone marrow was achieved in 66% of the patients and most patients achieved this after 18 weeks of treatment. An 87% OR (29% CR) was achieved in the lymph nodes. The median time to treatment failure has not yet been reached (18+ months; range, 8-44+ months). Transient injection site skin reactions were seen in 90% of patients. Rigor, rash, nausea, dyspnea, and hypotension were rare or absent. Transient grade IV neutropenia developed in 21% of the patients. Infections were rare, but 10% patients developed cytomegalovirus (CMV) reactivation. These patients rapidly responded to intravenous ganciclovir. One patient, allergic to cotrimoxazole prophylaxis, developed Pneumocystis carinii pneumonia. Alemtuzumab is highly effective as first-line treatment in patients with B-CLL. Prolonged treatment is important for maximal bone marrow response. Subcutaneous administration induced very few "first-dose" flulike symptoms and may reduce health care costs in comparison with the intravenous infusions.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Anticuerpos Monoclonales / Anticuerpos Antineoplásicos / Antígenos de Neoplasias / Antineoplásicos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Blood Año: 2002 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Anticuerpos Monoclonales / Anticuerpos Antineoplásicos / Antígenos de Neoplasias / Antineoplásicos Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Adult / Aged / Humans / Middle aged Idioma: En Revista: Blood Año: 2002 Tipo del documento: Article País de afiliación: Suecia Pais de publicación: Estados Unidos