Successful alemtuzumab retreatment in progressive B-cell chronic lymphocytic leukemia: a multicenter survey in 30 patients.

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BlankSuccessful alemtuzumab retreatment in progressive B-cell chronic

lymphocytic leukemia: a multicenter survey in 30 patients.

M Fiegl, F Falkner, M Steurer, N Zojer, G Hopfinger, F Haslbauer, G Winder, D

Voskova, J Andel, A Lang, Y Brychtova, J Mayer, R Greil, G Gastl, and for The

Austrian Collaborative Study Group on Alemtuzumab in Chronic Lymphocytic

Leukemia, in cooperation with The Czech Leukemia Study Group for Life, CELL

Ann Hematol, February 25, 2011

Department of Internal Medicine V, Division of Hematology and Oncology, Medical

University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria,

michael.fiegl@... .

Although retreatment with alemtuzumab in relapsing B-cell chronic lymphocytic

leukemia (CLL) may be beneficial, there has thus far been no thorough analysis

available on this topic. Data were collected from 30 chemotherapy-pretreated

patients with progressive CLL who had received alemtuzumab twice in consecutive,

distinct therapy lines. The median dose of alemtuzumab retreatment was 402?mg

(range, 43-1,090?mg). Retreatment with alemtuzumab induced an overall response

rate of 47%. From the start of alemtuzumab retreatment, median progression-free

survival (PFS) and overall survival (OS) were 6.3 and 20.0?months, respectively.

Response rates, PFS and OS upon alemtuzumab retreatment were correlated with

response to initial alemtuzumab treatment, the time interval between the initial

course of alemtuzumab and start of retreatment, and the hemoglobin concentration

prior to retreatment. Reported toxicities from 24 cases included infections

(50%), febrile reactions upon alemtuzumab administration (38%), exanthema (21%),

and grade 4 neutropenia (13%) and thrombocytopenia (17%). We conclude that

alemtuzumab retreatment represents an effective and tolerable therapeutic option

for selected patients with CLL.

PMID: 21350830