Long‐term efficacy and safety of alemtuzumab in advanced primary cutaneous T‐cell lymphomas. (1st March 2014)

• Record Type: Journal Article
• Authors: de Masson, A.; Guitera, P.; Brice, P.; Moulonguet, I.; Mouly, F.; Bouaziz, J.‐D.; Battistella, M.; Madelaine, I.; Roux, J.; Ram‐Wolff, C.; Cayuela, J.‐M.; Bachelez, H.; Bensussan, A.; Michel, L.; Bagot, M.
• Is Part Of: British journal of dermatology. Volume 170:Number 3(2014:Mar.)
• Page Start: 720
• Page End: 724
• Publication Date: 2014-03-01
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.12690
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Alemtuzumab has been proposed as salvage therapy for refractory cutaneous T‐cell lymphomas (CTCLs). Long‐term follow‐up data are scarce. Objectives: To assess the efficacy and safety of alemtuzumab in the treatment of advanced CTCL. Methods: A multicentre retrospective analysis was carried out of 39 patients with advanced CTCL treated with alemtuzumab between 2003 and 2013. Results: Thirty‐nine patients (median age 62 years, range 20–83) with Sézary syndrome (SS, n = 23) or advanced mycosis fungoides (MF, n = 16) received alemtuzumab 30 mg two to three times per week for a median duration of 12 weeks (range 1–35). Fifteen patients received maintenance therapy for a median duration of 24 weeks (range 6–277). Eleven patients (28%) had transformed disease (MF, n = 10; SS, n = 1). After a median follow‐up of 24 months (range 0·3–124), eight patients (21%) were still alive. The overall response rate was 51% in the whole study group (partial response, n = 13; complete response, n = 7); 70% in patients with SS and 25% in patients with MF ( P = 0·009). The median time to progression was 3·4 months (range 0·4–42). Six patients (15%; SS, n = 5; MF, n = 1) remained progression free for > 2 years (median 56 months, range 28–117). Five patients experienced cutaneous large T‐cell transformation during alemtuzumab treatment and one patient developed primary cutaneous large B‐cell lymphoma. Twenty‐four patients (62%) had a grade three or higher infectious adverse event and 10 (26%) a haematological toxicity, which led to treatment discontinuation in 17 cases (44%) and death in two (5%). Conclusions: Alemtuzumab may induce long‐term remission in SS but seems ineffective in MF and transformed CTCL.