Treatment of patients with advanced mycosis fungoides and Sézary syndrome with alemtuzumab

Abstract

Our findings suggest that in heavily pretreated, refractory, advanced stage MF/SS, although alemtuzumab has biological activity, it is associated with significant toxicity and only modest clinical utility. As such, combination regimens incorporating alemtuzumab merit further investigation in this difficult to treat patient group.

Cutaneous T‐cell lymphoma: 2011 update on diagnosis, risk‐stratification, and management

“…Similar results, with no infectious complications, were recently reported in a small cohort of patients treated with modified, low-dose, subcutaneous alemtuzumab for 6 weeks [321]. In addition to hematologic toxicity, conventionally dosed alemtuzumab in advanced-stage MF/SS is associated with a high incidence of infectious complications [319,320,[322][323][324][325]. Overall, infectious complications have been observed in twothirds of treated patients, most of which are bacterial, including sepsis.…”

EORTC consensus recommendations for the treatment of mycosis fungoides/Sézary syndrome

“…74 Kennedy and colleagues treated 8 patients with relapsed or refractory advanced-stage CTCL with alemtuzumab. 132 Patients were given alemtuzumab (30 mg) intravenously three times per week for 12 weeks or until maximum response. The ORR was 38%, with 3 patients achieving a PR, 2 with stable disease and 3 with progressive disease during treatment.…”

“…All patients developed progressive disease within 4 months of starting alemtuzumab. 132 12.6.2.4. MTX.…”

Low-dose intermittent alemtuzumab in the treatment of Sezary syndrome: clinical and immunologic findings in 14 patients

“…20 In another study, a lower response rate was achieved (38%) in a total of eight patients with relapsed or refractory advanced stage CTCL; seven of these had MF/SS. 21 No complete remissions were obtained; moreover, the response duration was short, with all patients developing progressive disease within 4 months of starting alemtuzumab. A preliminary report from Zinzani et al suggested that a reduced-dose alemtuzumab schedule (10 mg three times a week for 1 month) had clinical activity in ten pre-treated T-cell lymphoma patients among whom four had MF.…”