Abstract
Progressive B-cell chronic lymphocytic leukemia (B-CLL) is often complicated by autoimmune hemolytic anemia (AIHA), which in some cases may be refractory to conventional therapy such as corticosteroids, rituximab and splenectomy. We report here on 5 patients (median age 66 years, range 59-69) with advanced B-CLL, all of whom developed severe transfusion-dependent AIHA resistant to conventional therapy and received subcutaneous (SC) or intravenous (IV) alemtuzumab, a humanized monoclonal antibody that targets the CD52 antigen as salvage treatment for AIHA. Alemtuzumab was well tolerated with only minor 'first dose' reactions. All 5 patients responded with a >or=2.0 g/dl rise in hemoglobin (Hb) concentration, in the absence of further transfusions, after a median time of 5 weeks (range 4-7), and the mean Hb increased from 7.2 g/dl at baseline to 11.9 g/dl at end of treatment. All patients remained stable, without further AIHA episodes, after a median follow-up time of 12 months with a mean Hb of 12.5 g/dl (range 12.2-12.9). For patients with severe, refractory CLL-related AIHA, who have not previously responded to conventional therapy, alemtuzumab is an effective agent.
Publication types
-
Research Support, Non-U.S. Gov't
MeSH terms
-
Aged
-
Alemtuzumab
-
Anemia, Hemolytic, Autoimmune / blood
-
Anemia, Hemolytic, Autoimmune / drug therapy*
-
Anemia, Hemolytic, Autoimmune / etiology
-
Anemia, Hemolytic, Autoimmune / surgery
-
Anemia, Hemolytic, Autoimmune / therapy
-
Antibodies, Monoclonal / therapeutic use*
-
Antibodies, Monoclonal, Humanized
-
Antibodies, Neoplasm / therapeutic use*
-
Antigens, CD / immunology
-
Antigens, Neoplasm / immunology
-
Antineoplastic Agents, Alkylating / therapeutic use
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use
-
Blood Transfusion
-
CD52 Antigen
-
Chlorambucil / administration & dosage
-
Chlorambucil / therapeutic use
-
Combined Modality Therapy
-
Cyclophosphamide / administration & dosage
-
Drug Evaluation
-
Drug Resistance
-
Glycoproteins / immunology
-
Hemoglobins / analysis
-
Humans
-
Immunosuppressive Agents / therapeutic use
-
Leukemia, Lymphocytic, Chronic, B-Cell / blood
-
Leukemia, Lymphocytic, Chronic, B-Cell / complications*
-
Leukemia, Lymphocytic, Chronic, B-Cell / immunology
-
Male
-
Middle Aged
-
Prednisone / administration & dosage
-
Splenectomy
-
Treatment Outcome
-
Vidarabine / administration & dosage
-
Vidarabine / analogs & derivatives
-
Vincristine / administration & dosage
Substances
-
Antibodies, Monoclonal
-
Antibodies, Monoclonal, Humanized
-
Antibodies, Neoplasm
-
Antigens, CD
-
Antigens, Neoplasm
-
Antineoplastic Agents, Alkylating
-
CD52 Antigen
-
CD52 protein, human
-
Glycoproteins
-
Hemoglobins
-
Immunosuppressive Agents
-
Chlorambucil
-
Alemtuzumab
-
Vincristine
-
Cyclophosphamide
-
Vidarabine
-
fludarabine
-
Prednisone