Alemtuzumab for relapsed and refractory erythrodermic cutaneous T-cell lymphoma: A single institution experience from the Robert H. Lurie Comprehensive Cancer Center

Christiane Querfeld, Neha Mehta, Steven T. Rosen, Joan Guitart, Alfred Rademaker, Pedram Gerami, Timothy M. Kuzel

Research output: Contribution to journalArticlepeer-review

88 Scopus citations

Abstract

We present the results of an open-label clinical trial and the clinical use of alemtuzumab in 19 heavily pretreated patients with advanced erythrodermic cutaneous T-cell lymphomas (CTCL) (erythrodermic mycosis fungoides and Szary syndrome). Ten patients received alemtuzumab intravenously using an escalating dose regimen with a final dose of 30mg three times weekly for 4 weeks followed by subcutaneous administration for 8 weeks. Nine patients were treated with only the SQ or IV dosing. The overall response rate was 84%, with 9 (47%) complete and 7 (37%) partial remissions. The median follow-up was 24 months (range, 6 to 62+ months). Median overall survival was 41 months whereas median progression free survival was 6 months. Minimal residual disease by T-cell gene rearrangement studies was detected in 11 patients who achieved complete response and partial response. Toxicities included myelosuppression and infections; however, the majority of side effects were of Grade 2 in severity and transient. One patient was diagnosed with a concurrent lymphoma (mantle cell lymphoma) 6 months after completing alemtuzumab therapy. Alemtuzumab is particularly effective in patients with erythrodermic CTCL with acceptable toxicities. Combined strategies with alemtuzumab may achieve molecular remissions with longer response durations.

Original languageEnglish (US)
Pages (from-to)1969-1976
Number of pages8
JournalLeukemia and Lymphoma
Volume50
Issue number12
DOIs
StatePublished - Dec 2009

Keywords

  • Alemtuzumab
  • CD52 molecule
  • Erythrodermic CTCL
  • Minimal residual disease
  • Targeted therapy

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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