Plasma alemtuzumab levels in patients with chronic lymphocytic leukemia treated with alemtuzumab combined with chemotherapy reflect the efficacy of the treatment: a hypothesis. Issue 4 (April 2013)

• Record Type: Journal Article
• Authors: Vojdeman, Fie Juhl; Jurlander, Jesper; Veer, Mars van't; Itälä-Remes, Maija; Kimby, Eva; Tjønnfjord, Geir Erland; Walewski, Jan; Kozák, Tomas; Polliack, Aaron; Montagna, Michela; Regazzi, Mario; Kirkby, Nikolai; Oers, Marinus van; Geisler, Christian Hartmann
• Is Part Of: Leukemia & lymphoma. Volume 54:Issue 4(2013:Apr.)
• Page Start: 790
• Page End: 793
• Publication Date: 2013-04
• Subjects: Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2012.720373
• Languages: English
• ISSNs: 1042-8194

Abstract

<abstract> <title>Abstract</title> <p>In the HOVON68 trial comparing subcutaneous low-dose alemtuzumab (LD-A) used together with fludarabine (F) and cyclophosphamide (C) with FC alone in high-risk chronic lymphocytic leukemia (CLL), LD-AFC resulted in significantly more clinical and molecular responses than FC, but also in more opportunistic infections. In a subgroup analysis of alemtuzumab trough levels during treatment by a sensitive enzyme-linked immunosorbent assay (ELISA) method, detectable levels were found in 4/6 complete and 0/3 partial responders. A relationship between alemtuzumab plasma levels, response and duration of lymphocytopenia was evident. We hypothesize that following combination therapy, the response may not be a function of the alemtuzumab levels, but the opposite, that plasma alemtuzumab levels are a function of the efficacy of the entire treatment, and the fewer leukemic target cells that are remaining, the higher are the levels of plasma alemtuzumab. This concept may well provide a guide for alemtuzumab dosage in future trials.</p> </abstract>