Plasma alemtuzumab levels in patients with chronic lymphocytic leukemia treated with alemtuzumab combined with chemotherapy reflect the efficacy of the treatment - an hypothesis

Fie Juhl Vojdeman, Jesper Jurlander, Mars Van't Veer, Maija Itälä-Remes, Eva Kimby, Geir Erland Tjønnfjord, Jan Walewski, Tomas Kozák, Aaron Polliack, Michela Montagna, Mario Regazzi, Nikolai Kirkby, Marinus van Oers, Christian Hartmann Geisler

2 Citationer (Scopus)

Abstract

ABSTRACT 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 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 less leukemic target cells remaining, the higher the levels of plasma alemtuzumab. This concept may well provide a guide for alemtuzumab dosage in future trials.
OriginalsprogEngelsk
TidsskriftLeukemia and Lymphoma
Vol/bind54
Udgave nummer4
Sider (fra-til)790-93
ISSN1042-8194
DOI
StatusUdgivet - 2013

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