Abstract
We explored the safety and efficacy of rituximab plus alemtuzumab in patients with relapsed or refractory lymphoid malignancies. Forty-eight patients were treated and were assessable for response (32 with chronic lymphocytic leukemia [CLL], 9 with CLL/prolymphocytic leukemia [PLL], 1 with PLL, 4 with mantle cell leukemia/lymphoma, 2 with Richter transformation). The overall response rate was 52% (complete remission, 8%; nodular partial response, 4%; partial response, 40%). With a median follow-up of 6.5 months (range, 1-20 months), the median time to progression was 6 months (range, 1-20 months); median survival, 11 months (11+ months for responders vs 6 months for nonresponders). Most toxicities were grade 2 or lower and infusion-related. Infections occurred in 52% of the patients. Cytomegalovirus (CMV) antigenemia assays were positive in 27% of the patients, but only 15% were symptomatic and required therapy. The combination of rituximab and alemtuzumab is feasible, has an acceptable safety profile, and has clinical activity with a short course in a group of patients with poor prognoses.
MeSH terms
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Adult
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Aged
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Alemtuzumab
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / pharmacology
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Antibodies, Monoclonal, Humanized
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Antibodies, Monoclonal, Murine-Derived
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Antibodies, Neoplasm / administration & dosage
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Antibodies, Neoplasm / adverse effects
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Antibodies, Neoplasm / pharmacology
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Antigens, CD / immunology
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Antigens, CD20 / immunology
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Antigens, Neoplasm / immunology
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Apoptosis / drug effects
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CD52 Antigen
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Cytomegalovirus Infections / epidemiology
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Disease Progression
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Feasibility Studies
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Female
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Glycoproteins / immunology
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Humans
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Immunization, Passive*
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Infections / epidemiology
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Lymphoma / immunology
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Lymphoma / mortality
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Lymphoma / therapy*
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Male
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Middle Aged
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / immunology
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / mortality
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Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy*
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Recurrence
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Remission Induction
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Rituximab
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Safety
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Salvage Therapy
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Survival Analysis
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Treatment Outcome
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Antibodies, Monoclonal, Murine-Derived
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Antibodies, Neoplasm
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Antigens, CD
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Antigens, CD20
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Antigens, Neoplasm
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CD52 Antigen
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CD52 protein, human
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Glycoproteins
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Alemtuzumab
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Rituximab