Assessing Alemtuzumab Therapy in T-Prolymphocytic Leukemia
To determine the impact of the anti-CD52 monoclonal antibody alemtuzumab in T-Prolymphocytic Leukemia (T-PLL), Mayo Clinic researchers, Department of Laboratory Medicine author Jennifer Oliveira, M.D., conducted a single-center retrospective analysis. Published in the Clinical Lymphoma, Myeloma, and Leukemia journal, researchers studied the route of alemtuzumab administration compared to non-alemtuzumab-containing regimens in T-PLL.
The study consisted of 41 adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014. The diagnosis was determined per the World Health Organization 2008 classification.
According to the assessment, after a median follow-up of 18 months, 78 percent of the patients had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. The median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies.
Additionally, researchers identified a significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months. Further, only 14 percent of 28 patients aged under 70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of four months.
Based on these results, Mayo Clinic confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Moving forward, early transplant referral should be considered for all eligible patients.