Alemtuzumab therapy for hypereosinophilic syndrome and chronic eosinophilic Leukemia

Srdan Verstovsek, AyalewTefferi, Hagop Kantarjian, Taghi Manshouri, Raja Luthra, Animesh Pardanani, Alfonso Quintás-Cardama, Farhad Ravandi, Pat Ault, Carlos Bueso-Ramos, Jorge E. Cortes

Research output: Contribution to journalArticle

59 Scopus citations

Abstract

Purpose: Patients with hypereosinophilic syndrome (HES) or chronic eosinophilic leukemia (CEL) that are refractory to standard therapies are difficult to manage and have significantly shortened life expectancy. Experimental Design: CD52 is a surface glycoprotein highly expressed on eosinophils. We treated 11 patients with advanced HES/CEL with alemtuzumab, a humanized anti-CD52 monoclonal antibody. Alemtuzumab was administered, in general, first in escalating doses (5, 10, 30 mg i.v. on days 1-3), then at the tolerated dose thrice per week for a total of 12 doses. Patients with complete hematologic response (CHR; normal percent and absolute eosinophil count) were allowed to continue therapy once weekly as maintenance. Results: Ten patients (91%) achieved CHR after a median of 2 weeks (0.5-5 weeks) of therapy. Bone marrow eosinophilia resolved in four of seven evaluable patients. The median duration of CHR was 3 months (1.5-17+ months). Seven of the 10 CHR patients relapsed, five while off-therapy. Two patients achieved second CHR upon alemtuzumab rechallenge. Three patients experienced mild infusion-related symptoms, two developed cytomegalovirus reactivation requiring therapy, and one developed orbital lymphoma that was successfully treated. Conclusions: Our limited experience suggests alemtuzumab to be a valuable therapy for advanced HES or CEL, refractory to standard therapies, and supports the clinical evaluation of alemtuzumab in a larger trial.

Original languageEnglish (US)
Pages (from-to)368-373
Number of pages6
JournalClinical Cancer Research
Volume15
Issue number1
DOIs
StatePublished - Jan 1 2009

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Verstovsek, S., AyalewTefferi, Kantarjian, H., Manshouri, T., Luthra, R., Pardanani, A., Quintás-Cardama, A., Ravandi, F., Ault, P., Bueso-Ramos, C., & Cortes, J. E. (2009). Alemtuzumab therapy for hypereosinophilic syndrome and chronic eosinophilic Leukemia. Clinical Cancer Research, 15(1), 368-373. https://doi.org/10.1158/1078-0432.CCR-08-1302