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ctt-journal > Zagoskina 2 et al. (Abstract)

Zagoskina 2 et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract40
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Monoclonal anti-CD52 antibody treatment in chronic lymphocytic leukemia patients that are refractory to fludarabine-containing chemotherapy regimens

Tamara P. Zagoskina, Ekaterina N. Zotina, Irina V. Grishina, Valentina I. Demyanova

FGI «Kirov Institute of Hematology and Blood Transfusion of FMBA of Russia», Kirov, Russia

Correspondence: Tamara P. Zagoskina, FGI «Kirov Institute of Hematology and Blood Transfusion of FMBA of Russia», 72, Krasnoarmeiskaya str., 610027, Kirov, Russia, E-mail: zagoskina@spam is badblood.kirov.ru

Abstract

Anti-СD52 monoclonal antibody (alemtuzumab) is a new treatment option in chronic lymphocytic leukemia (CLL).

Aims. To study the efficiency and toxicity of alemtuzumab in a monoregimen in recurrence and refractory CLL.

Materials and methods. Twelve CLL patients (11 male and 1 female) were included in the study. The age of the patients ranged from 36 to 66 years (median: 54). Nine patients were in stage В, and 3 in stage С according to the Binet classification. The ECOG performance status was ≤2 balls. The median time from diagnosis until alemtuzumab treatment was 16 months (range, 1–28). Nine patients received FC, FCM, and RFC treatment, 3 of them were refractory to the FC program, and 1 to FCM. Five CLL patients were in relapse, 3 of these after FC (6 courses), one after FCM (4 courses), and one after RFC (6 courses). The remaining three patients were treatment-naïve. In all tested patients ZAP-70 protein expression before treatment was revealed by using flow cytometry on more than 20% lymphocytes and expression membrane antigen CD38 on more than 30% lymphocytes. The average β2-microglobuline level in blood serum was 5.92±0.8 mg/l (3.91–8.7 mg/l). Cytomegalovirus (CMV) screening was done by serology and the PCR-method before alemtuzumab therapy. CMV monitoring was undertaken every 2 weeks and if a fever of unknown origin occurred.

Alemtuzumab therapy was performed in a monoregimen by subcutaneous injection with dose escalation (3mg, 10 mg, 30 mg) by 30 mg 3 times a week. The treatment duration was 14 weeks in 1 patient, 12 weeks in 9 patients, and 8 weeks in 2 patients.

Results. As a first line therapy alemtuzumab induced complete remission in 2 patients after 6 and 8 weeks of treatment, which progressed to molecular remission; one patient developed partial remission. Among the patients resistant to earlier treatment and with relapse, overall response was achieved in 8 (89%) patients, complete remission developed in 5 (56%) patients, and partial remission in 3 (33%). One (11%) patient had no remission on therapy. It is necessary to note that in 3 (60%) patients with complete clinical and morphological remission, molecular remission developed too. The results of the study have shown that a response on alemtuzumab therapy depends on the duration of this therapy and the spread of the tumor process.

Conclusions. Monoclonal anti-CD52 antibodies are high effective among CLL patients that are refractory to fludarabine-containing chemotherapy regimens, and with the relapses of the disease, but toxicity was considerable.

Keywords: chronic lymphocytic leukemia, resistant forms, relapse, alemtuzumab

 

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