Alemtuzumab in the Treatment of Chronic Lymphocytic Leukemia
作者:
Tadeusz Robak,
期刊:
BioDrugs
(ADIS Available online 2005)
卷期:
Volume 19,
issue 1
页码: 9-22
ISSN:1173-8804
年代: 2005
出版商: ADIS
关键词: Alemtuzumab, general;Chronic lymphocytic leukaemia, general;Haematological malignancies, general;Monoclonal antibodies, general;Stem cell transplant
数据来源: ADIS
摘要:
Alemtuzumab is a humanized therapeutic monoclonal antibody (MAb) that recognizes the CD52 antigen, expressed on normal and neoplastic lymphocytes, monocytes, and natural killer cells. In 2001, alemtuzumab was approved in the US and Europe to treat B-cell chronic lymphocytic leukemia (CLL) that had been treated previously with alkylating agents and was refractory to fludarabine. In heavily pretreated patients this MAb is able to produce response rates of about 40%, and in symptomatic, previously untreated patients response rates of more than 80% can be achieved. Alemtuzumab can also be used in patients with CLL as a preparative regimen for stem cell transplantation (SCT) and to prevent graft versus host disease. Moreover itsin vivouse before or after SCT may also potentially result in depletion of residual leukemia cells, especially in the autologous setting. Adverse events associated with alemtuzumab include acute first-dose reaction, hematologic toxicity, and infectious complications. Usually they are predictable, manageable, and acceptable in the context of CLL. However, in a significant percentage of patients, cytomegalovirus reactivation occurs during alemtuzumab therapy, and routine weekly monitoring with the polymerase chain reaction methodology is indicated. Moreover, antiviral and antibacterial prophylaxis is mandatory.
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