Impact of alemtuzumab therapy and route of administration in T-prolymphocytic leukemia: A single-center experience

Moussab Damlaj, Nanna H. Sulai, Jennifer Oliveira, Rhett P. Ketterling, Shahrukh Hashmi, Thomas Elmer Witzig, Grzegorz S Nowakowski, Timothy G. Call, Tait D. Shanafelt, Wei D Ding, William Hogan, Mark R Litzow, Mrinal M Patnaik

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL). Patients and Methods The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014. Results A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56%) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78%) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P =.0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P =.0014). Only 4 (14%) of 28 patients aged <70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months. Conclusion In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.

Original languageEnglish (US)
Pages (from-to)699-704
Number of pages6
JournalClinical Lymphoma, Myeloma and Leukemia
Volume15
Issue number11
DOIs
StatePublished - Nov 1 2015

Fingerprint

Prolymphocytic Leukemia
Therapeutics
Survival
Hematopoietic Stem Cell Transplantation
alemtuzumab
Tertiary Care Centers
Referral and Consultation
Transplantation
Monoclonal Antibodies
Observation

Keywords

  • Alemtuzumab
  • GVHD
  • HSCT
  • T-PLL

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

Cite this

Impact of alemtuzumab therapy and route of administration in T-prolymphocytic leukemia : A single-center experience. / Damlaj, Moussab; Sulai, Nanna H.; Oliveira, Jennifer; Ketterling, Rhett P.; Hashmi, Shahrukh; Witzig, Thomas Elmer; Nowakowski, Grzegorz S; Call, Timothy G.; Shanafelt, Tait D.; Ding, Wei D; Hogan, William; Litzow, Mark R; Patnaik, Mrinal M.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 15, No. 11, 01.11.2015, p. 699-704.

Research output: Contribution to journalArticle

@article{c41a593898464df39ce982fa1533d288,
title = "Impact of alemtuzumab therapy and route of administration in T-prolymphocytic leukemia: A single-center experience",
abstract = "Objective We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL). Patients and Methods The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014. Results A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56{\%}) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78{\%}) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P =.0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P =.0014). Only 4 (14{\%}) of 28 patients aged <70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months. Conclusion In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.",
keywords = "Alemtuzumab, GVHD, HSCT, T-PLL",
author = "Moussab Damlaj and Sulai, {Nanna H.} and Jennifer Oliveira and Ketterling, {Rhett P.} and Shahrukh Hashmi and Witzig, {Thomas Elmer} and Nowakowski, {Grzegorz S} and Call, {Timothy G.} and Shanafelt, {Tait D.} and Ding, {Wei D} and William Hogan and Litzow, {Mark R} and Patnaik, {Mrinal M}",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.clml.2015.07.643",
language = "English (US)",
volume = "15",
pages = "699--704",
journal = "Clinical Lymphoma, Myeloma and Leukemia",
issn = "2152-2669",
publisher = "Cancer Media Group",
number = "11",

}

TY - JOUR

T1 - Impact of alemtuzumab therapy and route of administration in T-prolymphocytic leukemia

T2 - A single-center experience

AU - Damlaj, Moussab

AU - Sulai, Nanna H.

AU - Oliveira, Jennifer

AU - Ketterling, Rhett P.

AU - Hashmi, Shahrukh

AU - Witzig, Thomas Elmer

AU - Nowakowski, Grzegorz S

AU - Call, Timothy G.

AU - Shanafelt, Tait D.

AU - Ding, Wei D

AU - Hogan, William

AU - Litzow, Mark R

AU - Patnaik, Mrinal M

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Objective We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL). Patients and Methods The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014. Results A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56%) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78%) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P =.0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P =.0014). Only 4 (14%) of 28 patients aged <70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months. Conclusion In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.

AB - Objective We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL). Patients and Methods The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014. Results A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56%) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78%) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P =.0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P =.0014). Only 4 (14%) of 28 patients aged <70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months. Conclusion In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.

KW - Alemtuzumab

KW - GVHD

KW - HSCT

KW - T-PLL

UR - http://www.scopus.com/inward/record.url?scp=84946845030&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84946845030&partnerID=8YFLogxK

U2 - 10.1016/j.clml.2015.07.643

DO - 10.1016/j.clml.2015.07.643

M3 - Article

C2 - 26422251

AN - SCOPUS:84946845030

VL - 15

SP - 699

EP - 704

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

SN - 2152-2669

IS - 11

ER -