Remission of pure red cell aplasia in T-cell receptor γδ-large granular lymphocyte leukemia after therapy with low-dose alemtuzumab

Schützinger, Christian; Gaiger, A; Thalhammer, Renate; Vesely, Michael; Fritsche-Polanz, Robert; Schwarzinger, Ilse; Öhler, Leopold; Simonitsch‐Klupp, Ingrid; F, Reinhard; Jäger, Ulrich

doi:10.1038/sj.leu.2403956

Cited by 19 publications

(15 citation statements)

References 7 publications

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“…Alemtuzumab has been reported to be effective in anecdotal cases (Killick et al , 1997; Alvares et al , 2004; Au et al , 2005; Schützinger et al , 2005) or small series (Willis et al , 2001; Gómez‐Almaguer et al , 2009; Kim et al , 2009). Here we report the largest experience to date using alemtuzumab in SAA, PRCA and PWCA.…”

Section: Resultsmentioning

confidence: 99%

Alemtuzumab is safe and effective as immunosuppressive treatment for aplastic anaemia and single‐lineage marrow failure: a pilot study and a survey from the EBMT WPSAA

et al. 2010

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SummaryAn alemtuzumab-based experimental immunosuppressive treatment (IST) regimen was investigated in 35 patients with severe aplastic anaemia (SAA), pure red cell (PRCA) or pure white cell aplasia (PWCA). Alemtuzumab total dose was 73-103 mg s.c., followed by cyclosporine. No serious toxicity due to the regimen was observed. Adverse events were clinically irrelevant; infectious events were rare. The total response rate was 58%, 84% and 100% in SAA, PRCA and PWCA, respectively, with corresponding 6 months cumulative response probabilities of 84%, 84% and 100%. Subcutaneous alemtuzumab is a feasible and sufficiently safe IST regimen for patients suffering from immune-mediated marrow failures.

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Section: Resultsmentioning

confidence: 99%

Alemtuzumab is safe and effective as immunosuppressive treatment for aplastic anaemia and single‐lineage marrow failure: a pilot study and a survey from the EBMT WPSAA

et al. 2010

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“…Five patients with refractory WA-AIHA or pure red cell aplasia have been successfully treated with the anti CD52 antibody alemtuzumab [142][143][144][145][146][147]. Interestingly, one patient was refractory to rituximab but responded to alemtuzumab both in terms of lymphoma-regression and remission of AIHA [143].…”

Section: Second Line Therapiesmentioning

confidence: 99%

Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review

Valent

Lechner

2008

Wien Klin Wochenschr

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Autoimmune haemolytic anaemia (AIHA) is an immune disorder caused by antibodies directed against unmodified autologous red cells. The disorder may be a primary (idiopathic) or a secondary disease. The diagnosis is based on the presence of anaemia, signs of haemolysis with reticulocytosis, low haptoglobin, increased lactate dehydrogenase, elevated indirect bilirubin, and a positive direct antiglobulin test (Coombs test). Sometimes, not all of these typical features are present. Most AIHA are caused by warm antibodies, whereas cold antibodies are less commonly detected. While half of the warm antibody-based AIHA are idiopathic anaemias, almost all cold antibody AIHA are secondary anaemias. Underlying diseases are Non Hodgkin's lymphomas and systemic autoimmune disorders, and less frequently organ transplantation, infections, or solid tumors. Moreover, AIHA is an important complication of treatment with nucleoside analogs. Most patients with AIHA require therapy. In warm antibody AIHA, standard first line therapy are glucocorticosteroids with or without high dose immunoglobulins, whereas splenectomy is considered second-line therapy. Response rates of primary AIHA to corticosteroid therapy are high. After initial remission, the dose should be tapered down slowly and with caution, and in some cases, low-dose maintenance therapy is required. The efficacy of standard therapy is low in secondary AIHA that develops in lymphoma patients, posttransplant patients, or tumor patients. Among other immunosuppressive treatments, rituximab (anti-CD20) appears to be highly effective in patients with warm antibody AIHA refractory to standard therapy. Mycophenolate mofetil is quite effective in AIHA patients with an underlying autoimmune or lymphoproliferative disease. Patients with cold agglutinins are refractory to steroids and splenectomy. Half of these patients may respond to rituximab, although responses usually are short-lived. Sometimes, AIHA that is associated with malignant lymphomas or tumors, disappears after successful anti-lymphoma or anti-tumor therapy.

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“…The overall response rate on 26 patients is reported at more than 60%. 12,13,69,75,[83][84][85][86][87][88] However, toxicity limits use of this drug in an indolent disease. Furthermore, CD52 has significantly lower expression in leukemic LGL compared with CD8 ϩ normal T cells, and this could explain therapeutic failure in some patients.…”

Section: Campathmentioning

confidence: 99%

How I treat LGL leukemia

Lamy

Loughran

2011

Blood

248

300

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Remission of pure red cell aplasia in T-cell receptor γδ-large granular lymphocyte leukemia after therapy with low-dose alemtuzumab

Cited by 19 publications

References 7 publications

Alemtuzumab is safe and effective as immunosuppressive treatment for aplastic anaemia and single‐lineage marrow failure: a pilot study and a survey from the EBMT WPSAA

Alemtuzumab is safe and effective as immunosuppressive treatment for aplastic anaemia and single‐lineage marrow failure: a pilot study and a survey from the EBMT WPSAA

Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review

How I treat LGL leukemia

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