Alemtuzumab for B-cell chronic lymphocytic leukemia

Abstract

Alemtuzumab (Campath^®, MabCampath^®) is a humanized therapeutic monoclonal antibody (mAb) that recognizes the CD52 antigen expressed on normal and neoplastic lymphoid cells. This mAb is active in previously treated patients with B-cell chronic lymphocytic leukemia (B-CLL) refractory to alkylating agents and purine nucleoside analogs. Alemtuzumab is also investigated in previously untreated patients with this leukemia. The results of a prospective randomized Phase III study (CAM307 trial) comparing chlorambucil with alemtuzumab in the first-line treatment of progressive B-CLL were recently published. The overall response rate, complete remission rate, and progression-free survival were all superior for alemtuzumab. Moreover, elimination of minimal residual disease occurred in one third of complete responders to alemtuzumab and none to chlorambucil. Adverse events were similar in both arms with the exception of infusion-related reactions and cytomegalovirus infections. In 2001, alemtuzumab was approved in the USA and Europe as a third-line therapy for patients with B-CLL who had been treated with alkylating agents and failed fludarabine therapy. In September 2007, the US FDA, on the basis of CAM307 results, approved alemtuzumab for the treatment of previously untreated patients with B-CLL. Moreover, the European Commission recently granted marketing authorization to alemtuzumab for the treatment of patients with B-CLL for whom fludarabine combination monotherapy is not appropriate.

Keywords::

• AIHA
• alemtuzumab
• clinical trial
• chronic lymphocytic leukemia
• CMV
• first-line therapy
• immunochemotherapy
• minimal residual disease
• monoclonal antibodies
• nucleoside analog
• stem cell transplantation

Financial & competing interests disclosure

The work was supported by the Foundation for Development of Diagnostics and Therapy, Warsaw, Poland and by the grant from the Medical University of Lodz No. 503-1093-1. The author has received research funding from Genzyme Corp. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.