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Intensified alemtuzumab-CHOP therapy for peripheral T-cell lymphoma.
Kluin-Nelemans, H C; van Marwijk Kooy, M; Lugtenburg, P J; van Putten, W L J; Luten, M; Oudejans, J; van Imhoff, G W.
Afiliación
  • Kluin-Nelemans HC; Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen. Electronic address: j.c.kluin@int.umcg.nl.
  • van Marwijk Kooy M; Department of Internal Medicine, Isala klinieken, Zwolle.
  • Lugtenburg PJ; Department of Hematology.
  • van Putten WLJ; HOVON Data Center, Erasmus University Medical Center, Rotterdam.
  • Luten M; HOVON Data Center, Erasmus University Medical Center, Rotterdam.
  • Oudejans J; Department of Pathology, Diakonessenhuis, Utrecht, The Netherlands.
  • van Imhoff GW; Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen.
Ann Oncol ; 22(7): 1595-1600, 2011 Jul.
Article en En | MEDLINE | ID: mdl-21212158
BACKGROUND: The prognosis of T-cell lymphoma is poor. To explore the addition of the monoclonal antibody alemtuzumab, we studied the efficacy and tolerability of an intensified alemtuzumab-chemotherapy combination for aggressive T-cell lymphoma in a phase II study by Dutch-Belgian Hemato-Oncology Group (HOVON). PATIENTS AND METHODS: Patients (≤65 years) with newly diagnosed T-cell lymphoma received eight CHOP cycles (cyclophosphamide, doxorubicin, vincristine, prednisone) 2-weekly, each cycle with three doses of 30 mg alemtuzumab. Prophylaxis consisted of cotrimoxazole, fluconazole and valaciclovir. Cytomegalovirus (CMV) monitoring took place at least every fortnight. RESULTS: Twenty patients from 10 centers, median age 50 years, were included. Eighty-five percent received six or more cycles. The overall response was 90% [12 complete remissions (CRs), 1 CR unconfirmed, 5 partial remissions]. Median duration of follow-up of patients still alive was 29 months (range 19-41 months). Median overall survival (OS) and event-free survival (EFS) were 27 and 10 months, with 55%/27% OS/EFS at 2 years. Adverse events consisted of neutropenic fever (n = 8) and CMV reactivation (n = 7), with one CMV disease. Three patients developed secondary Epstein-Barr virus (EBV)-related lymphoma, all after end of treatment. CONCLUSIONS: Although intensified alemtuzumab-CHOP induces high responses, many patients relapse, and the scheme is associated with serious infection-related adverse events. EBV monitoring after end of treatment is required.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Linfoma de Células T Periférico Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Oncol Asunto de la revista: NEOPLASIAS Año: 2011 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Protocolos de Quimioterapia Combinada Antineoplásica / Linfoma de Células T Periférico Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Ann Oncol Asunto de la revista: NEOPLASIAS Año: 2011 Tipo del documento: Article Pais de publicación: Reino Unido