Phase II study of alemtuzumab (CAMPATH-1) in patients with HTLV-1-associated adult T-cell leukemia/lymphoma

Kamal Sharma, John E. Janik, Deirdre O'Mahony, Donn Stewart, Stefania Pittaluga, Maryalice Stetler-Stevenson, Elaine S. Jaffe, Mark Raffeld, Thomas A. Fleisher, Cathryn C. Lee, Seth M. Steinberg, Thomas A. Waldmann, John C. Morris

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Purpose: Therapeutic regimens for adult T-cell leukemia/lymphoma (ATL) are limited with unsatisfactory results, thereby warranting development of novel therapies. This study investigated antitumor activity and toxicity of alemtuzumab with regard to response, duration of response, progression-free survival, and overall survival in patients with human T-cell lymphotropic virus-1 (HTLV-1)-associated ATL. Experimental Design: Twenty-nine patients with chronic, acute, and lymphomatous types of ATL were enrolled in a singleinstitution, nonrandomized, open-label phase II trial wherein patients received intravenous alemtuzumab 30 mg three times weekly for a maximum of 12 weeks. Results: Twenty-nine patients were evaluable for response and toxicity. The overall objective response was 15 of 29 patients [95% confidence interval (CI), 32.5%-70.6%]. The 15 patients who responded manifested a median time to response of 1.1 months. Median response duration was 1.4 months for the whole group and 14.5 months among responders. Median progression-free survival was 2.0 months. Median overall survival was 5.9 months. The most common adverse events were 2 with vasovagal episodes (7%) and 3 with hypotensive episodes (10%), leukopenia (41%) grade 3 and (17%) grade 4, lymphocytopenia (59%) grade 3, neutropenia (31%) grade 3, anemia (24%), and thrombocytopenia (10%). All patients developed cytomegalovirus antigenemia (CMV). Three were symptomatic and all responded to antiviral therapy. Grade 3 or 4 infections were reported in 4 (14%) of patients. Conclusions: Alemtuzumab induced responses in patients with acute HTLV-1-associated ATL with acceptable toxicity, but with short duration of responses. These studies support inclusion of alemtuzumab in novel multidrug therapies for ATL.

Original languageEnglish (US)
Pages (from-to)35-42
Number of pages8
JournalClinical Cancer Research
Volume23
Issue number1
DOIs
StatePublished - Jan 1 2017

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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    Sharma, K., Janik, J. E., O'Mahony, D., Stewart, D., Pittaluga, S., Stetler-Stevenson, M., Jaffe, E. S., Raffeld, M., Fleisher, T. A., Lee, C. C., Steinberg, S. M., Waldmann, T. A., & Morris, J. C. (2017). Phase II study of alemtuzumab (CAMPATH-1) in patients with HTLV-1-associated adult T-cell leukemia/lymphoma. Clinical Cancer Research, 23(1), 35-42. https://doi.org/10.1158/1078-0432.CCR-16-1022