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ctt-journal > Zotina et al. (Abstract)

Zotina et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 12
doi: 10.3205/ctt-2011-No12-abstract48

© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "5th Raisa Gorbacheva Memorial Meeting Hematopoietic Stem Cell Transplantation in Children and Adults", Saint Petersburg, Russia, September 18–20, 2011

Preliminary Program

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Indicators of immunity in patients with chronic lymphocytic leukemia during treatment with monoclonal anti-CD52 antibodies

Ekaterina N. Zotina, Tamara P. Zagoskina, Olga V. Malykh, Victor I. Shardakov, Anna V. Yovdy

FGI "Kirov Institute of Hematology and Blood Transfusion of FMBA of Russia", Kirov, Russia

Correspondence: Ekaterina N. Zotina, FGI "Kirov Institute of Hematology and Blood Transfusion of FMBA of Russia", 72, Krasnoarmeiskaya str., 610027, Kirov, Russia, E-mail: enzotina@spam is badmail.ru

Abstract

Current treatment options in chronic lymphocytic leukemia (CLL) include humanized monoclonal anti-CD52 antibody (alemtuzumab). By binding to the CD52 antigen, alemtuzumab leads to death not only of the tumor cells but also normal cells; this dramatically reduces the body’s immunocompetence and increases the risk of infectious complications.

Aim: To study the influence of immunochemotherapy with alemtuzumab on the cellular and humoral immunity in patients with CLL.

Materials and methods: The study included 35 CLL patients aged from 36 to 69 years (median 54 years), 18 of which received alemtuzumab monotherapy, while 17 patients were treated with a FluCam program (fludarabine and alemtuzumab). Treatment was carried out according to standard protocols. Their immune status was assessed before treatment, during treatment, and 3 months after its completion. We investigated the content of the major lymphocyte subsets in peripheral blood (CD3+, CD4+, CD8+, CD20+, CD22+, CD16+, CD25+, CD95+, and HLA-DR+), and serum immunoglobulin classes G, A, and M. The comparison group included 50 primary blood donors, matched for age.

Results: Before treatment, the CLL patients had a significant reduction in the relative number of CD3+, CD4+, CD8+, and CD16+-cells (1.4, 1.6, 1.3, and 1.5-fold, respectively), and immunoregulatory index CD4+/CD8+ (1.3-fold) compared with those of healthy controls (p<0.01). In the course of treatment and 3 months after its completion there was a statistically significant reduction in the relative number of CD3+, CD4+, CD8+, and CD20+-lymphocytes, and an increase in the percentage of CD16+-cells compared with the baseline (p<0.01). The concentration of serum immunoglobulin classes G, A, and M before treatment was significantly lower than in the control group (1.6, 2.0 and 2.1-fold respectively). During the treatment, all of them changed significantly (p>0.05).

Conclusions: In CLL patients prior to treatment we observed pronounced changes in cellular and humoral immunity. The use of monoclonal anti-CD52 antibody aggravates existing disorders of cellular immunity; however, it does not cause further depression of humoral immunity.

Keywords: chronic lymphocytic leukemia, immune system, anti-CD52 monoclonal antibody, alemtuzumab, fludarabine