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Vol. 13, Art. 19 (pp. 229-241)    |    2012       

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The use of alemtuzumab in therapy of t-cell lymphoma

1 Bessmeltsev S.S., 2 Zagoskina T.P., 3 Kariagina E.V.

1 Russian Research Institute of Hematology and Transfusiology,

2 Kirov’s Institute of Hematology and Transfusiology,

3 City Hospital 15

Brief summary

The clinical course of T-cell lymphoma is usually aggressive and the prognosis unfavorable. We report the activity of alemtuzumab (Campath) in 14 patients with T-cell lymphoma including 8 patients with mycosis fungoides/Sézary syndrome. Alemtuzumab (Campath-1H) is a monoclonal antibody directed against the lymphocytic antigen CD52, expressed on B- and T-cells. Patients with newly diagnosed (n = 4) or refractory/relapsed (n = 10) T-cell lymphoma received alemtuzumab or alemtuzumab in combination with fludarabine (FluCam). Patients received valacyclovir and trimethoprim/sulfamethoxazole for antiinfective prophylaxis. Response to therapy, overall survival, as well as adverse events were assessed. 8 patients received alemtuzumab. The overall response rate (ORR) was 100%. 6 patients had complete response. 6 patients received FluCam. The ORR was 50% (complete response+ partial response). Median duration of follow-up of patients still alive was 6-42 months. Median overall survival in patients treated with alemtuzumab or alemtuzumab in combination with fludarabine has been not reached. Extremely high efficiency алемтузумаба in group of patients with mycosis fungoides attracts attention. 5 patients had complete response. Median overall survival in patients with mycosis fungoides has been not reached. The 3-year overall survival was 100%. Preliminary data also suggest that alemtuzumab may have activity in newly diagnosed patients and patients with heavily pretreated patients with T-cell lymphoma who are refractory to conventional chemotherapy. The main complication of therapy was related to myelosuppression and infection. We conclude that the alemtuzumab demonstrated significant efficacy in patients with T-cell lymphoma, with tolerable toxicity.


Key words

T-cell lymphoma, mycosis fungoides/Sézary syndrome, alemtuzumab, complete response

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