Pflug, Natali, Cramer, Paula, Robrecht, Sandra, Bahlo, Jasmin, Westermann, Anne, Fink, Anna-Maria, Schrader, Alexandra, Mayer, Petra, Oberbeck, Sebastian, Seiler, Till, Zenz, Thorsten, Duerig, Jan, Kreuzer, Karl-Anton, Stilgenbauer, Stephan, Eichhorst, Barbara, Hallek, Michael, Herling, Marco and Hopfinger, Georg (2019). New lessons learned in T-PLL: results from a prospective phase-II trial with fludarabine-mitoxantrone-cyclophosphamide-alemtuzumab induction followed by alemtuzumab maintenance. Leuk. Lymphoma, 60 (3). S. 649 - 658. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1029-2403

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Abstract

Clinical trials in T-cell prolymphocytic leukemia (T-PLL) are scarce. Based on a precursor study testing fludarabine, mitoxantrone, and cyclophosphamide followed by alemtuzumab (FMC-A), we aimed to improve this regimen by upfront combining subcutaneous (s.c.) alemtuzumab with FMC for four cycles followed by an alemtuzumab-maintenance (FMCA + A). This prospective multicenter phase-II trial assessed response, survival, and toxicity of that regimen administered to pretreated (n = 4) and treatment-naive (n = 12) T-PLL patients. The best overall response rate after FMCA was 68.8% (n = 11) including five CRs (31.3%) and six PRs (37.5%). Six patients entered the alemtuzumab-maintenance. Median overall and progression-free survival was 16.7 and 11.2 months, respectively. Hematologic toxicities were the most frequent grade 3/4 side effects. A reduced incidence of CMV-reactivations was attributed to the prophylactic administration of valganciclovir. Overall, FMCA + A did not improve the efficacy of the FMC-A-regimen or of single i.v. alemtuzumab. It suggests that a chemotherapy backbone prevents efficient alemtuzumab dosing and confirms that intravenous alemtuzumab is to be preferred over its s.c. route in T-PLL. ClinicalTrials.gov identifier: NCT01186640.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Pflug, NataliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cramer, PaulaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Robrecht, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bahlo, JasminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Westermann, AnneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fink, Anna-MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schrader, AlexandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayer, PetraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oberbeck, SebastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seiler, TillUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zenz, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Duerig, JanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kreuzer, Karl-AntonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stilgenbauer, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eichhorst, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hallek, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herling, MarcoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hopfinger, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-156335
DOI: 10.1080/10428194.2018.1488253
Journal or Publication Title: Leuk. Lymphoma
Volume: 60
Number: 3
Page Range: S. 649 - 658
Date: 2019
Publisher: TAYLOR & FRANCIS LTD
Place of Publication: ABINGDON
ISSN: 1029-2403
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CELL PROLYMPHOCYTIC LEUKEMIA; THERAPY; CHOP; CHEMOIMMUNOTHERAPY; BENDAMUSTINE; CHEMOTHERAPY; LYMPHOMASMultiple languages
Oncology; HematologyMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/15633

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