skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8838

Alemtuzumab in the treatment of fludarabine refractory B-cell chronic lymphocytic leukemia (CLL)

Review

(2934) Views  (609) Full article downloads

Authors: Marco Montillo, Francesca Ricci, Sara Miqueleiz, Alessandra Tedeschi, Enrica Morra

Published Date March 2008 Volume 2008:2(1) Pages 41 - 52
DOI: http://dx.doi.org/10.2147/BTT.S1397

Marco Montillo, Francesca Ricci, Sara Miqueleiz, Alessandra Tedeschi, Enrica Morra

Department of Oncology/Hematology, Division of Hematology and Bone Marrow Transplant Unit, Niguarda Ca’ Granda Hospital, Milan, Italy

Abstract: The introduction of immunotherapeutic agents has provided renewed hope for Chronic lymphocytic leukemia fludarabine-refractory patients. Several clinical trials have shown that alemtuzumab is a more effective option compared to combination chemotherapy for treatment of patients who have relapsed or who are refractory to fludarabine, including those with poor prognostic factors. Although there are significant potential toxicities associated with alemtuzumab, such as infusional reactions and the risk of cytomegalovirus (CMV) reactivation, most are manageable. Pre-treatment anti-pyretics and anti-histamines are recommended to prevent or mitigate the acute infusional reactions associated with intravenous infusion. Recent use of alemtuzumab via the subcutaneous route has been shown to be well tolerated and has yielded similar response rates to the infusional method of administration. Prophylaxis with thrimethoprim/sulphamethoxazole (TMP/SMZ) as well as valacyclovir or a similar anti-viral can prevent many of the opportunistic infections seen in early trials. Reactivation of CMV infection can be effectively managed with monitoring and early treatment. Chemo-immunotherapy combination with alemtuzumab has been tested and demonstrated unprecedented clinical results in relapsed and refractory patients. The use of this agent earlier in the algorithm of patients with these characteristics should be considered. Future areas of research will include the use of alemtuzumab in combination with other monoclonal antibodies and other targeted therapies.

Keywords: chronic lymphocytic leukemia, fludarabine, alemtuzumab






 

Other articles by Dr Marco Montillo



Readers of this article also read:

Activity of the lipoxygenase inhibitor 1-phenyl-3-pyrazolidinone (phenidone) and derivatives on the inhibition of adhesion molecule expression on human umbilical vascular endothelial cells
The potential role of curcumin (diferuloylmethane) in plasma cell dyscrasias/paraproteinemia
α-L-iduronidase therapy for mucopolysaccharidosis type I
Gamma knife radiosurgery for uveal melanoma ineligible for brachytherapy by the Collaborative Ocular Melanoma Study criteria
Long term management of patients with cryopyrin-associated periodic syndromes (CAPS): focus on rilonacept (IL-1 Trap)
Etiology of hypercoagulable state in women with recurrent fetal loss without other causes of miscarriage from Southern Italy: new clinical target for antithrombotic therapy
Therapeutic vaccines for malignant brain tumors
Gene targeted therapeutics for liver disease in alpha-1 antitrypsin deficiency
Abatacept in difficult-to-treat juvenile idiopathic arthritis
Periosteoplasty for covering gingival recessions: Clinical results
  • Testimonials

    "... I was impressed at the rapidity of publication from submission to final acceptance." Dr Edwin Thrower, PhD, Yale University

  • Journal Indexing

    See where all the Dove Press journals are indexed