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First-line treatment of chronic lymphocytic leukemia: role of alemtuzumab

Authors Carmen Diana Schweighofer, Clemens-Martin Wendtner

Published 30 March 2010 Volume 2010:3 Pages 53—67

DOI http://dx.doi.org/10.2147/OTT.S3099

Review by Single-blind

Peer reviewer comments 2

Carmen Diana Schweighofer1, Clemens-Martin Wendtner2

1Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; 2Department of Internal Medicine I, University of Cologne, Cologne, Germany

Abstract: The CD52-targeting antibody alemtuzumab is established in clinical practice with convincing activity in relapsed and refractory chronic lymphocytic leukemia (CLL), particularly in patients with high-risk features and adverse prognosis. In the CAM307 study alemtuzumab was tested and finally approved as a first-line single agent, even though the hurdle with chlorambucil as the contender was not set very high. Within clinical trials, the drug demonstrated an excellent ability to eliminate minimal residual disease in blood and bone marrow, which has been correlated with a corresponding survival advantage in patients. However, in the maintenance setting, infectious complications due to severe T cell suppression have been highlighted and do not allow clinicans to use alemtuzumab outside of clinical trials. This review discusses potential therapeutic niches and future applications of alemtuzumab with a focus on CLL front-line treatment.
Keywords: CLL, alemtuzumab, Campath, front-line, first-line treatment

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