An Italian retrospective study on the routine clinical use of low-dose alemtuzumab in relapsed/refractory chronic lymphocytic leukaemia patients

Agostino Cortelezzi, Giuseppe Gritti, Luca Laurenti, Antonio Cuneo, Stefania Ciolli, Nicola Di Renzo, Pellegrino Musto, Francesca R. Mauro, Nicola Cascavilla, Lorenzo Falchi, Francesco Zallio, Vincenzo Callea, Francesco Maura, Sara Martinelli, Alfonso Piciocchi, Gianluigi Reda, Robin Foà

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Abstract

Low-dose alemtuzumab has shown a favourable toxicity profile coupled with good results in terms of efficacy in relapsed/refractory chronic lymphocytic leukaemia (CLL). We conducted a multicentre retrospective study on the routine clinical use of low-dose alemtuzumab in this patient setting. One hundred and eight relapsed/refractory CLL patients from 11 Italian centres were included in the analysis. All patients had an Eastern Cooperative Oncology Group performance status ≤2 and the majority (84%) had adenopathies <5 cm. Low-dose alemtuzumab was defined as a total weekly dose ≤45 mg and a cumulative dose ≤600 mg given for up to 18 weeks. The overall response rate was 56% (22% complete remissions). After a median follow-up of 42.2 months, the median overall survival and progression-free survival were 39.0 and 19.4 months, respectively. In univariate analysis, response was inversely associated with lymph node (P = 0.01) and spleen (P = 0.02) size, fludarabine-refractoriness (P = 0.01) and del(11q) (P = 0.009). Advanced age and del(17p) were not associated with a worse outcome. Cumulative dose of alemtuzumab was not associated to response. Toxicities were usually mild and manageable; severe infections occurred in seven patients (7%) during therapy. This retrospective analysis confirms that low-dose alemtuzumab is a valid and currently used therapeutic option for the treatment of relapsed/refractory CLL.
Original languageEnglish
Pages (from-to)481-489
Number of pages9
JournalBritish Journal of Haematology
Volume156
DOIs
Publication statusPublished - 2012

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • Female
  • Humans
  • Italy
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

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