PURPOSE: Patients with hypereosinophilic syndrome (HES) or chronic eosinophilic leukemia (CEL) that are refractory to standard therapies are difficult to manage and have significantly shortened life expectancy. EXPERIMENTAL DESIGN: CD52 is a surface glycoprotein highly expressed on eosinophils. We treated 11 patients with advanced HES/CEL with alemtuzumab, a humanized anti-CD52 monoclonal antibody. Alemtuzumab was administered, in general, first in escalating doses (5, 10, 30 mg i.v. on days 1-3), then at the tolerated dose thrice per week for a total of 12 doses. Patients with complete hematologic response (CHR; normal percent and absolute eosinophil count) were allowed to continue therapy once weekly as maintenance. RESULTS: Ten patients (91%) achieved CHR after a median of 2 weeks (0.5-5 weeks) of therapy. Bone marrow eosinophilia resolved in four of seven evaluable patients. The median duration of CHR was 3 months (1.5-17+ months). Seven of the 10 CHR patients relapsed, five while off-therapy. Two patients achieved second CHR upon alemtuzumab rechallenge. Three patients experienced mild infusion-related symptoms, two developed cytomegalovirus reactivation requiring therapy, and one developed orbital lymphoma that was successfully treated. CONCLUSIONS: Our limited experience suggests alemtuzumab to be a valuable therapy for advanced HES or CEL, refractory to standard therapies, and supports the clinical evaluation of alemtuzumab in a larger trial.
PURPOSE:Patients with hypereosinophilic syndrome (HES) or chronic eosinophilic leukemia (CEL) that are refractory to standard therapies are difficult to manage and have significantly shortened life expectancy. EXPERIMENTAL DESIGN:CD52 is a surface glycoprotein highly expressed on eosinophils. We treated 11 patients with advanced HES/CEL with alemtuzumab, a humanized anti-CD52 monoclonal antibody. Alemtuzumab was administered, in general, first in escalating doses (5, 10, 30 mg i.v. on days 1-3), then at the tolerated dose thrice per week for a total of 12 doses. Patients with complete hematologic response (CHR; normal percent and absolute eosinophil count) were allowed to continue therapy once weekly as maintenance. RESULTS: Ten patients (91%) achieved CHR after a median of 2 weeks (0.5-5 weeks) of therapy. Bone marrow eosinophilia resolved in four of seven evaluable patients. The median duration of CHR was 3 months (1.5-17+ months). Seven of the 10 CHR patients relapsed, five while off-therapy. Two patients achieved second CHR upon alemtuzumab rechallenge. Three patients experienced mild infusion-related symptoms, two developed cytomegalovirus reactivation requiring therapy, and one developed orbital lymphoma that was successfully treated. CONCLUSIONS: Our limited experience suggests alemtuzumab to be a valuable therapy for advanced HES or CEL, refractory to standard therapies, and supports the clinical evaluation of alemtuzumab in a larger trial.
Authors: F Vega; L J Medeiros; D Jones; L V Abruzzo; R Lai; J Manning; V Dunmire; R Luthra Journal: Am J Clin Pathol Date: 2001-07 Impact factor: 2.493
Authors: Roberto H Nussenzveig; Sabina I Swierczek; Jaroslav Jelinek; Amos Gaikwad; Enli Liu; Srdan Verstovsek; Jaroslav F Prchal; Josef T Prchal Journal: Exp Hematol Date: 2007-01 Impact factor: 3.084
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Authors: Peter Valent; Gerald J Gleich; Andreas Reiter; Florence Roufosse; Peter F Weller; Andrzej Hellmann; Georgia Metzgeroth; Kristin M Leiferman; Michel Arock; Karl Sotlar; Joseph H Butterfield; Sabine Cerny-Reiterer; Matthias Mayerhofer; Peter Vandenberghe; Torsten Haferlach; Bruce S Bochner; Jason Gotlib; Hans-Peter Horny; Hans-Uwe Simon; Amy D Klion Journal: Expert Rev Hematol Date: 2012-04 Impact factor: 2.929
Authors: Michael E Wechsler; Patricia C Fulkerson; Bruce S Bochner; Gail M Gauvreau; Gerald J Gleich; Tim Henkel; Roland Kolbeck; Sameer K Mathur; Hector Ortega; Jatin Patel; Calman Prussin; Paolo Renzi; Marc E Rothenberg; Florence Roufosse; Dagmar Simon; Hans-Uwe Simon; Andrew Wardlaw; Peter F Weller; Amy D Klion Journal: J Allergy Clin Immunol Date: 2012-09 Impact factor: 10.793