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Alemtuzumab plus CHOP as front-line chemotherapy for patients with peripheral T-cell lymphomas: a phase II study

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Abstract

Purpose

The present study was conducted to evaluate the safety and efficacy of alemtuzumab plus CHOP chemotherapy for patients with peripheral T-cell lymphomas (PTCLs).

Patients and methods

Twenty patients with newly diagnosed PTCLs were enrolled. The treatment consisted of classical CHOP plus alemtuzumab (10 mg i.v. on day 1 and 20 mg i.v. on day 2 in the first cycle, then 30 mg i.v. on day 1 in the subsequent cycles) based on 3-week intervals.

Results

Thirteen complete responses (65.0%) and three partial responses (15.0%) were confirmed, giving an overall response rate of 80.0%. The estimated event-free survival at 1 year was 43.3%. The most severe hematologic adverse event was neutropenia, which occurred with a grade-4 intensity in 18 patients (90.0%). Also, febrile neutropenia was observed in 11 patients (55.0%). Five patients (25%) experienced cytomegalovirus (CMV) reactivation, while three patients developed CMV diseases, such as pneumonitis or retinitis. There were two treatment-related deaths. Based on the high incidence of the adverse infectious and hematologic events, the current study was closed after 20 of the planned 43 patients had been enrolled.

Conclusion

The alemtuzumab plus CHOP chemotherapy seemed to produce active antitumor activity in terms of the complete response rates in patients with PTCLs. However, since high infectious and hematologic toxicities were observed, careful monitoring and early treatment are needed to prevent treatment-related mortality.

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References

  1. Gordon LI, Harrington D, Anderson J, Colgan J, Glick J, Neiman R, Mann R, Resnick GD, M Barcos, Gottlieb A (1992) Comparison of a second generation combination chemotherapeutic regimen (m-BACOD) with a standard regimen (CHOP) for advanced diffuse non-Hodgkin’s lymphoma. N Engl J Med 327:1342–1349

    Article  PubMed  CAS  Google Scholar 

  2. Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman CA Jr, Miller TP (1993) Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin’s lymphoma. N Engl J Med 328:1002–1006

    Article  PubMed  CAS  Google Scholar 

  3. Lee CH, Im YH, Ryoo BY, Nam SM, Kim MS, Lee YS, Oh KK, Shim YS, Yoo SY, Lee JO, Kang YK (1998) Primary CHOP chemotherapy followed by involved field radiation therapy in clinical stage I or II aggressive non-Hodgkin’s lymphomas. Cancer Res Treat 30:809–817

    Google Scholar 

  4. Harris NL, Jaffe ES, Stein H, Banks PM, Chan JKC, Cleary ML, Delsol G, De Wolf-Peters C, Falini B, Gatter KC, Grogan TM, Isaacson PG, Knowles DM, Mason DY, Muller-Hermelink H, Pileri SA, Piris MA, Ralfkiaer E, Warnke RA (1994) A revised European–American classification of lymphoid neoplasms: a proposal from the International Lymphoma Study Group. Blood 84:1361–1392

    PubMed  CAS  Google Scholar 

  5. Melnyk A, Rodrguez A, Pugh WC, Cabannillas F. Evaluation of the revised European–American lymphoma classification confirms the clinical relevance of immunophenotype in 560 cases of aggressive non-Hodgkin’s lymphoma. Blood 89:4514–4520

  6. McLaughlin P, Grillo-Lopez AJ, Link BK, Levy R, Czuczman MS, Williams ME, Heyman MR, Bence-Bruckler I, White CA, Cabanillas F, Jain V, Ho AD, Lister J, Wey K, Shen D, Dallaire BK (1998) Rituximab chimeric anti-CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncol 16:2825–2833

    PubMed  CAS  Google Scholar 

  7. Feugier P, Van Hoof A, Sebban C, Solal-Celigny P, Bouabdallah R, Ferme C, Christian B, Lepage E, Tilly H, Morschauser F, Gaulard P, Salles G, Bosly A, Gisselbrecht C, Reyes F, Coiffier B (2005) Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol 23:4117–4126

    Article  PubMed  CAS  Google Scholar 

  8. Salisbury JR, Rapson NT, Codd JD, Rogers MV, Nethersell AB (1994) Immunohistochemical analysis of CDw52 antigen expression in non-Hodgkin’s lymphomas. J Clin Pathol 47:313–317

    PubMed  CAS  Google Scholar 

  9. Ginaldi L, De Martinis M, Matutes E, Farahat N, Morilla R, Dyer MJ, Catovsky V (1998) Levels of expression of CD 52 in normal and leukemic B and T cells: correlations with in vivo therapeutic responses to Campath-1H. Leuk Res 22:185–191

    Article  PubMed  CAS  Google Scholar 

  10. Lundin J, Kimby E, Bjorkholm M, Broliden PA, Celsing F, Hjalmar V, Mollgard L, Rebello P, Hale G, Waldmann H, Mellstedt H, Osterborg A (2002) Phase II trial of subcutaneous anti-CD52 monoclonal antibody alemtuzumab (Campath) as first line treatment for patients with B-cell chronic lymphocytic leukemia. Blood 100:768–773

    Article  PubMed  CAS  Google Scholar 

  11. Dearden CE, Matutes E, Cazin B, Tjonnfjord GE, Parreira A, Nomdedeu B, Leoni P, Clark FJ, Radia D, Rassam SM, Roques T, Ketterer N, Brito-Babapulle V, Dyer MJ, Catovsky D (2001) High remission rate in T-cell prolymphocytic leukemia with Campath-1H. Blood 98:1721–1726

    Article  PubMed  CAS  Google Scholar 

  12. Lundin J, Hagberg H, Repp R, Cavallin-Stahl E, Freden S, Juliusson G, Rosenblad E, Tjonnfjord G, Wiklund T, Osterborg A (2003) Phase 2 study of alemtuzumab (anti-CD52 monoclonal antibody) in patients with advanced mycosis fungoides/Sezary syndrome. Blood 101:4267–4272

    Article  PubMed  CAS  Google Scholar 

  13. Enblad G, Hagberg H, Erlanson M, Lunding J, MacDonald AP, Repp R, Schetelig J, Seipelt G, Osterborg A (2004) A pilot study of alemtuzumab (anti-CD52 monoclonal antibody) therapy for patients with relapsed or chemotherapy-refractory peripheral T-cell lymphomas. Blood 103:2920–2924

    Article  PubMed  CAS  Google Scholar 

  14. Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM, Lister TA, Vose J, Grillo-Lopez A, Hagenbeek A, Cabanillas F, Klippensten D, Hiddemann W, Castellino R, Harris NL, Armitage JO, Carter W, Hoppe R, Canellos GP (1999) Report of an international workshop to standardize response criteria for non-Hodgkin’s lymphoma. J Clin Oncol 17:1244–1253

    PubMed  CAS  Google Scholar 

  15. Simon R (1989) Optimal two-stage designs for phase II clinical trials. Control Clin Trials 10:1–10

    Article  PubMed  CAS  Google Scholar 

  16. Gisselbrecht C, Gaulard P, Lepage E, Coiffier B, Briere J, Haioun C, Cazals-Hatem D, Bosly A, Xerri L, Tilly H, Berger F, Bouhabdallah R, Diebold J (1998) Prognostic significance of T-cell phenotype in aggressive non-Hodgkin’s lymphomas. Blood 92:76–82

    PubMed  CAS  Google Scholar 

  17. Kim K, Kim WS, Jung CW, Im YH, Kang WK, Lee MH, Park CH, Ko YH, Ree HJ, Park K (2002) Clinical features of peripheral T-cell lymphomas in 78 patients diagnosed according to the revised European–American lymphoma (REAL) classification. Eur J Cancer 38:75–81

    Article  PubMed  CAS  Google Scholar 

  18. Kim JG, Sohn SK, Chae YS, Kim DH, Baek JH, Lee KB, Lee JJ, Chung IJ, Kim HJ, Yang DH, Lee WS, Joo YD, Sohn CH (2006) CHOP plus etoposide and gemcitabine (CHOP-EG) as front-line chemotherapy for patients with peripheral T cell lymphomas. Cancer Chemother Pharmacol 58:35–39

    Article  PubMed  CAS  Google Scholar 

  19. Keating MJ, Flinn I, Jain V, Binet JL, Hillmen P, Byrd J, Albitar M, Brettman L, Santabarbara P, Wacker B, Rai KR (2002) Therapeutic role of alemtuzumab (Campath-1H) in patients who have failed fludarabine: results of a large international study. Blood 99:3554–3561

    Article  PubMed  CAS  Google Scholar 

  20. Lundin J, Porwit-MacDonald A, Rossmann ED, Karlsson C, Edman P, Rezvany MR, Kimby E, Osterborg A, Mellstedt H (2004) Cellular immune reconstitution after subcutaneous alemtuzumab (anti-CD52 monoclonal antibody, Campath-1H) treatment as first-line therapy for B-cell chronic lymphocytic leukemia. Leukemia 18:484–490

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Hematology/Oncology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, 50 Samduck 2-Ga, Jung-Gu, Daegu, 700-721, South Korea

    Jong Gwang Kim, Sang Kyun Sohn, Yee Soo Chae & Yoon Young Cho

  2. Department of Hematology/Oncology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, South Korea

    Deok Hwan Yang, Je-Jung Lee & Hyeoung-Joon Kim

  3. Department of Hematology/Oncology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea

    Ho Jin Shin, Joo Seop Chung & Goon Jae Cho

  4. Department of Hematology/Oncology, Busan Paik Hospital, Inje University, Busan, South Korea

    Won-Sik Lee, Young-Don Joo & Chang-Hak Sohn

  5. Division of Oncology-Hematology, Department of Internal Medicine, Kangbuk Samsung Hospital, School of Medicine, Sungkyunkwan University, Seoul, South Korea

    Suk Joong Oh

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  1. Jong Gwang Kim
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  2. Sang Kyun Sohn
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Correspondence to Sang Kyun Sohn.

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Kim, J.G., Sohn, S.K., Chae, Y.S. et al. Alemtuzumab plus CHOP as front-line chemotherapy for patients with peripheral T-cell lymphomas: a phase II study. Cancer Chemother Pharmacol 60, 129–134 (2007). https://doi.org/10.1007/s00280-007-0469-9

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  • DOI: https://doi.org/10.1007/s00280-007-0469-9

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