Chronic lymphocytic leucemia, MRD-negative remission with Alemtuzumab improves survival


The 84 percent of patients who had no detectable traces of chronic lymphocytic leukemia ( CLL ) after receiving Alemtuzumab had survived for at least 5 years.

A study, led by Peter Hillmen from the Leeds General Infirmary, Leeds ( UK ), evaluated whether eradication of minimal residual disease ( MRD ) in B-cell chronic lymphocytic leukemia by Alemtuzumab is associated with a prolongation of treatment-free and overall survival.

Alemtuzumab ( marketed as MabCampath in Europe and as CamPath in the United States ) is the first, and only, monoclonal antibody approved for the treatment of CLL.

Chronic lymphocytic leukaemia is the most prevalent form of adult leukemia affecting approximately 120,000 people in the United States and Europe.
The disease is characterized by the accumulation of functionally immature lymphocytes in the bone marrow, blood, lymph tissue, and other organs.
About 95 percent of CLL cases involve cancerous B cells.

" The success in achieving MRD negative remissions in this heavily pre-treated group of patients is one of the essential steps towards our long-term goal of curing CLL," Hillmen said.

Ninety-one previously-treated patients with CLL ( median age 58 years; 44 were refractory to purine analogs ) received a median of 9 weeks of Alemtuzumab treatment.

The 36 percent of patients achieved complete response ( CR ), partial remission ( PR ) in 19 percent, and no response ( NR ) in 46 percent.
The 50 percent of 44 purine analog-refractory patients responded toAlemtuzumab.
Detectable CLL was eradicated from the blood and marrow in 20 percent of patients.

Median survival was significantly longer for MRD-negative patients compared to those achieving an MRD-positive CR, PR, or NR.
Patients achieving an MRD-negative complete remission experienced a longer period of treatment-free survival than patients with MRD-positive CRs, PR, or NR: MRD-negative CRs, not reached; MRD-positive CRs, 20 months; PRs, 13 months; NR, 6 months ( P <.0001).

Source: Journal of Clinical Oncology , 2005


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