TY - JOUR
T1 - Phase II study of alemtuzumab in combination with pentostatin in patients with T-cell neoplasms
AU - Ravandi, Farhad
AU - Aribi, Ahmed
AU - O'Brien, Susan
AU - Faderl, Stefan
AU - Jones, Dan
AU - Ferrajoli, Alessandra
AU - Huang, Xuelin
AU - York, Sergernne
AU - Pierce, Sherry
AU - Wierda, William
AU - Kontoyiannis, Dimitrios
AU - Verstovsek, Srdan
AU - Pro, Barbara
AU - Fayad, Luis
AU - Keating, Michael
AU - Kantarjian, Hagop
PY - 2009/11/10
Y1 - 2009/11/10
N2 - Purpose: To examine the efficacy and safety of the combination of alemtuzumab and pentostatin in patients with T-cell neoplasms. Patients and Methods: We treated 24 patients with a variety of T-cell leukemias and lymphomas with a combination of alemtuzumab 30 mg intravenously (IV) three times weekly for up to 3 months and pentostatin 4 mg/m2 IV weekly for 4 weeks followed by alternate weekly administration for up to 6 months. Prophylactic antibiotics including antiviral, antifungal, and antibacterial agents were administered during the treatment and for 2 months after its completion. Results: The median age of patients was 57 years (range, 21 to 79 years). Eight patients were previously untreated, and 16 had a median of two prior therapies (range, one to six regimens). Thirteen patients responded to treatment (11 complete responses [CRs] and two partial responses), for an overall response rate of 54%. The median response duration was 19.5 months. Monoclonal T-cell receptor chain gene rearrangements were detected by polymerase chain reaction in bone marrow of 20 of 22 evaluable patients and became negative in five of seven evaluable patients in CR. Opportunistic infections caused by pathogens associated with severe T-cell dysfunction were common. Conclusion: The combination of alemtuzumab and pentostatin is feasible and effective in T-cell neoplasms. Although infections, including cytomegalovirus reactivation, are a concern, they may be minimized with adequate prophylactic antibiotic therapy.
AB - Purpose: To examine the efficacy and safety of the combination of alemtuzumab and pentostatin in patients with T-cell neoplasms. Patients and Methods: We treated 24 patients with a variety of T-cell leukemias and lymphomas with a combination of alemtuzumab 30 mg intravenously (IV) three times weekly for up to 3 months and pentostatin 4 mg/m2 IV weekly for 4 weeks followed by alternate weekly administration for up to 6 months. Prophylactic antibiotics including antiviral, antifungal, and antibacterial agents were administered during the treatment and for 2 months after its completion. Results: The median age of patients was 57 years (range, 21 to 79 years). Eight patients were previously untreated, and 16 had a median of two prior therapies (range, one to six regimens). Thirteen patients responded to treatment (11 complete responses [CRs] and two partial responses), for an overall response rate of 54%. The median response duration was 19.5 months. Monoclonal T-cell receptor chain gene rearrangements were detected by polymerase chain reaction in bone marrow of 20 of 22 evaluable patients and became negative in five of seven evaluable patients in CR. Opportunistic infections caused by pathogens associated with severe T-cell dysfunction were common. Conclusion: The combination of alemtuzumab and pentostatin is feasible and effective in T-cell neoplasms. Although infections, including cytomegalovirus reactivation, are a concern, they may be minimized with adequate prophylactic antibiotic therapy.
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U2 - 10.1200/JCO.2009.22.6688
DO - 10.1200/JCO.2009.22.6688
M3 - Article
C2 - 19805674
AN - SCOPUS:73949103860
SN - 0732-183X
VL - 27
SP - 5425
EP - 5430
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 32
ER -