PMID- 20225334
OWN - NLM
STAT- MEDLINE
DCOM- 20100525
LR  - 20191210
IS  - 0008-543X (Print)
IS  - 1097-0142 (Electronic)
IS  - 0008-543X (Linking)
VI  - 116
IP  - 10
DP  - 2010 May 15
TI  - Alemtuzumab by continuous intravenous infusion followed by subcutaneous injection 
      plus rituximab in the treatment of patients with chronic lymphocytic leukemia 
      recurrence.
PG  - 2360-5
LID - 10.1002/cncr.24958 [doi]
AB  - BACKGROUND: Monoclonal antibodies may be used more effectively in combination. A 
      previous study of intravenous (iv) bolus alemtuzumab plus rituximab in patients 
      with chronic lymphocytic leukemia (CLL) recurrence produced a response rate of 
      54% after a 4-week treatment period. METHODS: To optimize dose, schedule, and 
      route of alemtuzumab, a study was designed exploring continuous intravenous 
      infusion (civ) followed by subcutaneous (sc) alemtuzumab together with weekly iv 
      rituximab in patients with previously treated CLL. RESULTS: Data from 40 patients 
      with a median age of 59 years, and a median of 3 prior regimens (range, 1-8 
      regimens) were evaluable. Approximately 64% of patients were 
      fludarabine-refractory. Seven patients (18%) achieved a complete response (CR), 4 
      (10%) a nodular partial response (nPR), and 10 (25%) a partial response for an 
      overall response rate of 53%. Of 11 major responses (CR, nPR), 8 occurred after 
      cycle 1. Response rates were highest in blood (94%), followed by liver/spleen 
      (82%), bone marrow (68%), and lymph nodes (51%). The combination did not generate 
      unexpected toxicities. Cytomegalovirus (CMV) reactivations occurred in 6 patients 
      (15%) and responded well to anti-CMV therapy. High titers of anti-idiotype 
      antibodies after sc alemtuzumab were demonstrated in 1 patient, but remained 
      without clinical sequelae. CONCLUSIONS: The combination of civ/sc alemtuzumab 
      plus rituximab has activity in some patients with recurrent/refractory CLL and 
      maximum response is achieved after 1 cycle (4 weeks) in 73% of patients. Further 
      exploration in other settings of CLL together with accompanying pharmacokinetic 
      studies is recommended.
CI  - (c) 2010 American Cancer Society.
FAU - Faderl, Stefan
AU  - Faderl S
AD  - Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, 
      Houston, Texas 77030, USA. sfader@mdanderson.org
FAU - Ferrajoli, Alessandra
AU  - Ferrajoli A
FAU - Wierda, William
AU  - Wierda W
FAU - O'Brien, Susan
AU  - O'Brien S
FAU - Lerner, Susan
AU  - Lerner S
FAU - Keating, Michael J
AU  - Keating MJ
LA  - eng
GR  - P30 CA016672/CA/NCI NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Cancer
JT  - Cancer
JID - 0374236
RN  - 0 (Antibodies, Anti-Idiotypic)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antibodies, Monoclonal, Murine-Derived)
RN  - 0 (Antibodies, Neoplasm)
RN  - 3A189DH42V (Alemtuzumab)
RN  - 4F4X42SYQ6 (Rituximab)
SB  - IM
EIN - Cancer. 2010 Aug 15;116(16):3982. Dosage error in article text
MH  - Adult
MH  - Aged
MH  - Alemtuzumab
MH  - Antibodies, Anti-Idiotypic/metabolism
MH  - Antibodies, Monoclonal/*administration & dosage
MH  - Antibodies, Monoclonal, Humanized
MH  - Antibodies, Monoclonal, Murine-Derived
MH  - Antibodies, Neoplasm/*administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
MH  - Drug Administration Schedule
MH  - Female
MH  - Humans
MH  - Infections/etiology
MH  - Infusions, Intravenous
MH  - Injections, Subcutaneous
MH  - Leukemia, Lymphocytic, Chronic, B-Cell/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Recurrence
MH  - Rituximab
MH  - Treatment Outcome
PMC - PMC4476388
MID - NIHMS676526
COIS- Conflict Of Interest Disclosures: The authors made no disclosures.
EDAT- 2010/03/13 06:00
MHDA- 2010/05/26 06:00
PMCR- 2015/06/22
CRDT- 2010/03/13 06:00
PHST- 2010/03/13 06:00 [entrez]
PHST- 2010/03/13 06:00 [pubmed]
PHST- 2010/05/26 06:00 [medline]
PHST- 2015/06/22 00:00 [pmc-release]
AID - 10.1002/cncr.24958 [doi]
PST - ppublish
SO  - Cancer. 2010 May 15;116(10):2360-5. doi: 10.1002/cncr.24958.