Long-term follow-up of patients with hypereosinophilic syndrome treated with Alemtuzumab, an anti-CD52 antibody.
Long-term follow-up of patients with hypereosinophilic syndrome treated with Alemtuzumab, an anti-CD52 antibody.
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DOI：
10.1016/j.clml.2012.09.018
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发表时间：
2013-06
期刊：
影响因子：
--
通讯作者：
Verstovsek S
中科院分区：
文献类型：
--
作者：
Strati P;Cortes J;Faderl S;Kantarjian H;Verstovsek S
由于嗜酸性粒细胞表达CD 52抗原，12例难治性或复发性嗜酸性粒细胞增多综合征患者接受了Alemtuzumab（一种抗CD 52抗体）治疗。几乎所有患者的疾病体征和症状都迅速消除，维持治疗的患者反应持久性更好。在复发患者中使用Alemtuzumab再激发可重复产生相同的疗效。不良反应大多与免疫抑制有关。复发性难治性特发性嗜酸性粒细胞增多综合征（I-HES）和慢性嗜酸性粒细胞白血病-未另行说明（CEL-NOS）患者没有很多有效、持久的治疗选择。据报道，由于嗜酸性粒细胞上固有的CD 52表达，抗CD 52抗体Alemtuzumab是一种有效的治疗方法。对2012年之前在我中心接受Alemtuzumab治疗的12例患者进行的回顾性病历审查。12例患者中有10例（83%）在中位持续时间为66周的中位1周后达到完全血液学缓解（CR），疾病相关症状消除; 2例患者达到部分血液学缓解（PHR）。接受Alemtuzumab维持治疗的COPD患者（n = 5）的至进展时间显著长于仅接受观察的患者（n = 5）（P = .01）。11例患者复发（仅1例在维持治疗期间），6例接受Alemtuzumab再激发。5例（83%）患者在中位3.5周后获得第二次随访，中位持续时间为123周。同样，给予维持治疗的患者（n = 3）的疾病进展时间长于仅接受观察的患者（P = 0.04）。不良反应主要与输注反应和淋巴细胞减少相关的病毒感染有关（尽管进行了抗生素预防）。1例患者发生EB病毒相关淋巴瘤。阿来组单抗是复发性、难治性特发性嗜酸性粒细胞增多综合征和慢性嗜酸性粒细胞白血病患者的有效治疗方法-在CHR实现（即使在重复再激发后）和持续时间（特别是如果作为维持治疗提供）方面未另行说明。常见的不良反应与输液反应和免疫抑制有关。
Because eosinophils express CD52 antigen, 12 patients with refractory or relapsed hypereosinophilic syndrome were treated with alemtuzumab, an anti-CD52 antibody. Brisk elimination of signs and symptoms of the disease was achieved in almost all patients, with durability of response better in those on maintenance therapy. Rechallenge with alemtuzumab in relapsing patients yields the same efficacy repeatedly. Adverse effects are mostly related to immunosuppression. Relapsing, refractory patients with idiopathic hypereosinophilic syndrome (I-HES) and chronic eosinophilic leukemia–not otherwise specified (CEL-NOS) do not have many effective, durable therapeutic options. Alemtuzumab, an anti-CD52 antibody, has been reported to be an effective therapy due to inherent expression of CD52 on eosinophils. A retrospective chart review of 12 patients treated with alemtuzumab at our center until 2012. Ten (83%) of 12 patients achieved complete hematologic response (CHR) after a median of 1 week for a median duration of 66 weeks, with the elimination of disease-related symptoms; 2 patients achieved partial hematologic remission hematologic remission (PHR). Patients with CHR who received alemtuzumab maintenance (n = 5) had a significantly longer time to progression than those patients who were only observed (n = 5) (P = .01). Eleven patients relapsed (only one while on maintenance), and 6 were rechallenged with alemtuzumab. Five (83%) achieved second CHR after a median of 3.5 weeks, for a median duration of 123 weeks. Again, those given maintenance (n = 3) had a longer time to progression than those who were only observed (P = .04). Adverse effects were mostly related to infusion reactions and lymphopenia-related viral infections (despite antibiotic prophylaxis). One patient developed Epstein-Barr virus–related lymphoma. Alemtuzumab is an effective treatment for patients with relapsed, refractory idiopathic hypereosinophilic syndrome and chronic eosinophilic leukemia–not otherwise specified, in terms of both CHR achievement (even after repeated rechallenges) and duration (particularly if provided as a maintenance therapy). Common adverse effects are related to infusion reactions and immunosuppression.
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