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Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901.

Publication ,  Journal Article
Byrd, JC; Peterson, BL; Rai, KR; Hurd, D; Hohl, R; Perry, MC; Gockerman, J; Nattam, S; Larson, RA
Published in: Leuk Lymphoma
October 2009

The humanized anti-CD52 monoclonal antibody alemtuzumab is an effective therapy for chronic lymphocytic leukemia (CLL). We examined the impact of alemtuzumab treatment after initial fludarabine treatment for feasibility and safety. Patients (N = 85) with previously untreated symptomatic CLL received fludarabine (25 mg/m(2)/day) for 5 days every 4 weeks for four cycles followed by 2 months of observation. Patients with stable disease or better response then received alemtuzumab 30 mg three times weekly for 6 weeks either intravenously (IV; cohort 1; N = 39) or subcutaneously (SC; cohort 2; N = 20). Of the 85 evaluable patients enrolled on our study, four (5%) attained a complete response (CR) and 43 (51%) attained a partial response after fludarabine induction for an overall response rate (ORR) of 55%. Thirty-nine patients received IV alemtuzumab for consolidation with improvement in CR to 27% and ORR to 73%. Twenty patients received SC alemtuzumab consolidation with improvement in CR to 17% and ORR to 69%. Toxicity from IV alemtuzumab included infusion-related reactions and infection. Mild local inflammation was common from SC alemtuzumab but there were virtually no systemic side effects. Nine of 59 (15%) patients had cytomegalovirus (CMV) infections; one patient died. The administration of alemtuzumab as consolidation therapy following an abbreviated fludarabine induction is feasible but requires close monitoring for CMV infection and other infectious events.

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Published In

Leuk Lymphoma

DOI

EISSN

1029-2403

Publication Date

October 2009

Volume

50

Issue

10

Start / End Page

1589 / 1596

Location

United States

Related Subject Headings

  • Vidarabine
  • Survival Analysis
  • Neoplasm Proteins
  • Middle Aged
  • Male
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Injections, Subcutaneous
  • Infusions, Intravenous
  • Immunology
  • Hypotension
 

Citation

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Byrd, J. C., Peterson, B. L., Rai, K. R., Hurd, D., Hohl, R., Perry, M. C., … Larson, R. A. (2009). Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901. Leuk Lymphoma, 50(10), 1589–1596. https://doi.org/10.1080/10428190903150839
Byrd, John C., Bercedis L. Peterson, Kanti R. Rai, David Hurd, Raymond Hohl, Michael C. Perry, Jon Gockerman, Sreenivasa Nattam, and Richard A. Larson. “Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901.Leuk Lymphoma 50, no. 10 (October 2009): 1589–96. https://doi.org/10.1080/10428190903150839.
Byrd, John C., et al. “Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901.Leuk Lymphoma, vol. 50, no. 10, Oct. 2009, pp. 1589–96. Pubmed, doi:10.1080/10428190903150839.
Byrd JC, Peterson BL, Rai KR, Hurd D, Hohl R, Perry MC, Gockerman J, Nattam S, Larson RA. Fludarabine followed by alemtuzumab consolidation for previously untreated chronic lymphocytic leukemia: final report of Cancer and Leukemia Group B study 19901. Leuk Lymphoma. 2009 Oct;50(10):1589–1596.

Published In

Leuk Lymphoma

DOI

EISSN

1029-2403

Publication Date

October 2009

Volume

50

Issue

10

Start / End Page

1589 / 1596

Location

United States

Related Subject Headings

  • Vidarabine
  • Survival Analysis
  • Neoplasm Proteins
  • Middle Aged
  • Male
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Injections, Subcutaneous
  • Infusions, Intravenous
  • Immunology
  • Hypotension