High remission rate in T-cell prolymphocytic leukemia with CAMPATH-1H
High remission rate in T-cell prolymphocytic leukemia with CAMPATH-1H
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DOI：
10.1182/blood.v98.6.1721
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发表时间：
2001-09-15
期刊：
影响因子：
20.3
通讯作者：
Catovsky, D
中科院分区：
文献类型：
--
作者：
Dearden, CE;Matutes, E;Catovsky, D
T细胞幼淋巴细胞白血病（T-PLL）是一种化疗耐药的恶性肿瘤，中位生存期为7.5个月。初步结果表明，人CD 52抗体CAMPATH-1H具有高缓解诱导率。本研究报告了1993年3月至2000年5月期间接受CAMPATH-1H治疗的39例T-PLL患者的结果。除2例患者外，所有患者均接受过各种药物的既往治疗，包括30例喷司他丁;无一人达到完全缓解（CR）。CAMPATH-1H（30 mg）每周静脉注射3次，直至达到最大反应。总有效率为76%，其中CR为60%，部分缓解（PR）为16%。这些反应是持久的，中位无病间隔为7个月（范围，4-45个月）。与PR或无应答（NR）相比，达到CR的患者生存期显著延长，包括1例生存54个月的患者。9名患者在完成治疗后存活长达29个月。7例患者接受了自体干细胞支持的高剂量治疗，其中3例在自体移植后CR 5、7和15个月仍存活。双色流式细胞术和聚合酶链反应显示，这些患者的干细胞收获物未被T-PLL细胞污染。4例患者进行了异基因干细胞移植，3例来自同胞，1例来自匹配的无关供体。2例有非清髓性条件反射。3例在CR中存活至同种异体移植后24个月。结论是CAMPATH-1H是T-PLL的有效疗法，在超过三分之二的患者中产生缓解。使用干细胞移植巩固反应值得进一步研究。(C)2001年，美国血液学会。
T-cell prolymphocytic leukemia (T-PLL) is a chemotherapy-resistant malignancy with a median survival of 7.5 months. Preliminary results indicated a high remission induction rate with the human CD52 antibody, CAMPATH-1H. This study reports results in 39 patients with T-PLL treated with CAMPATH-1H between March 1993 and May 2000. All but 2 patients had received prior therapy with a variety of agents, including 30 with pentostatin; none achieved complete remission (CR). CAMPATH-1H (30 mg) was administered intravenously 3 times weekly until maximal response. The overall response rate was 76% with 60% CR and 16% partial remission (PR). These responses were durable with a median disease-free interval of 7 months (range, 4-45 months). Survival was significantly prolonged in patients achieving CR compared to PR or no response (NR), including one patient who survived 54 months. Nine patients remain alive up to 29 months after completing therapy. Seven patients received high-dose therapy with autologous stem cell support, 3 of whom remain alive in CR 5, 7, and 15 months after autograft. Stem cell harvests in these patients were uncontaminated with T-PLL cells as demonstrated by dual-color flow cytometry and polymerase chain reaction Four patients had allogeneic stem cell transplants, 3 from siblings and 1 from a matched unrelated donor. Two had nonmyeloablative conditioning. Three are alive in CR up to 24 months after allograft. The conclusion is that CAMPATH-1H is an effective therapy in T-PLL, producing remissions in more than two thirds of patients. The use of stem cell transplantation to consolidate responses merits further study. (C) 2001 by The American Society of Hematology.