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

Fie Juhl Vojdeman, Jesper Jurlander, Mars Van t Veer, Maija Itälä-Remes, Eva Kimby, Geir Erland Tjonnfjord, Jan Walewski, Tomas Kozák, Aaron Polliack, Michela Montagna, Mario Regazzi, Nikolai Kirkby, Marinus Van Oers, Christian Hartmann Geisler

Research output: Contribution to journalArticlepeer-review

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 enzyme-linked immunosorbent assay (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 fewer leukemic target cells that are remaining, the higher are the levels of plasma alemtuzumab. This concept may well provide a guide for alemtuzumab dosage in future trials.

Original languageEnglish
Pages (from-to)790-793
Number of pages4
JournalLeukemia and Lymphoma
Volume54
Issue number4
DOIs
Publication statusPublished - Apr 2013

Keywords

  • Alemtuzumab
  • Campath
  • Chronic lymphocytic leukemia
  • CLL
  • Immunochemotherapy
  • Pharmacokinetics

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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