BACKGROUND: Relapsing, refractory patients with idiopathic hypereosinophilic syndrome (I-HES) and chronic eosinophilic leukemia-not otherwise specified (CEL-NOS) do not have many effective, durable therapeutic options. Alemtuzumab, an anti-CD52 antibody, has been reported to be an effective therapy due to inherent expression of CD52 on eosinophils. METHODS: A retrospective chart review of 12 patients treated with alemtuzumab at our center until 2012. RESULTS: Ten (83%) of 12 patients achieved complete hematologic response (CHR) after a median of 1 week for a median duration of 66 weeks, with the elimination of disease-related symptoms; 2 patients achieved partial hematologic remission hematologic remission (PHR). Patients with CHR who received alemtuzumab maintenance (n = 5) had a significantly longer time to progression than those patients who were only observed (n = 5) (P = .01). Eleven patients relapsed (only one while on maintenance), and 6 were rechallenged with alemtuzumab. Five (83%) achieved second CHR after a median of 3.5 weeks, for a median duration of 123 weeks. Again, those given maintenance (n = 3) had a longer time to progression than those who were only observed (P = .04). Adverse effects were mostly related to infusion reactions and lymphopenia-related viral infections (despite antibiotic prophylaxis). One patient developed Epstein-Barr virus-related lymphoma. CONCLUSIONS: Alemtuzumab is an effective treatment for patients with relapsed, refractory idiopathic hypereosinophilic syndrome and chronic eosinophilic leukemia-not otherwise specified, in terms of both CHR achievement (even after repeated rechallenges) and duration (particularly if provided as a maintenance therapy). Common adverse effects are related to infusion reactions and immunosuppression.
BACKGROUND: Relapsing, refractory patients with idiopathic hypereosinophilic syndrome (I-HES) and chronic eosinophilic leukemia-not otherwise specified (CEL-NOS) do not have many effective, durable therapeutic options. Alemtuzumab, an anti-CD52 antibody, has been reported to be an effective therapy due to inherent expression of CD52 on eosinophils. METHODS: A retrospective chart review of 12 patients treated with alemtuzumab at our center until 2012. RESULTS: Ten (83%) of 12 patients achieved complete hematologic response (CHR) after a median of 1 week for a median duration of 66 weeks, with the elimination of disease-related symptoms; 2 patients achieved partial hematologic remission hematologic remission (PHR). Patients with CHR who received alemtuzumab maintenance (n = 5) had a significantly longer time to progression than those patients who were only observed (n = 5) (P = .01). Eleven patients relapsed (only one while on maintenance), and 6 were rechallenged with alemtuzumab. Five (83%) achieved second CHR after a median of 3.5 weeks, for a median duration of 123 weeks. Again, those given maintenance (n = 3) had a longer time to progression than those who were only observed (P = .04). Adverse effects were mostly related to infusion reactions and lymphopenia-related viral infections (despite antibiotic prophylaxis). One patient developed Epstein-Barr virus-related lymphoma. CONCLUSIONS:Alemtuzumab is an effective treatment for patients with relapsed, refractory idiopathic hypereosinophilic syndrome and chronic eosinophilic leukemia-not otherwise specified, in terms of both CHR achievement (even after repeated rechallenges) and duration (particularly if provided as a maintenance therapy). Common adverse effects are related to infusion reactions and immunosuppression.
Authors: Amy D Klion; Bruce S Bochner; Gerald J Gleich; Thomas B Nutman; Marc E Rothenberg; Hans-Uwe Simon; Michael E Wechsler; Peter F Weller Journal: J Allergy Clin Immunol Date: 2006-05-03 Impact factor: 10.793
Authors: Srdan Verstovsek; Ayalew Tefferi; Hagop Kantarjian; Taghi Manshouri; Raja Luthra; Animesh Pardanani; Alfonso Quintás-Cardama; Farhad Ravandi; Pat Ault; Carlos Bueso-Ramos; Jorge E Cortes Journal: Clin Cancer Res Date: 2009-01-01 Impact factor: 12.531
Authors: Jane F Apperley; Martine Gardembas; Junia V Melo; Robin Russell-Jones; Barbara J Bain; E Joanna Baxter; Andrew Chase; Judith M Chessells; Marie Colombat; Claire E Dearden; Sasa Dimitrijevic; François-X Mahon; David Marin; Zariana Nikolova; Eduardo Olavarria; Sandra Silberman; Beate Schultheis; Nicholas C P Cross; John M Goldman Journal: N Engl J Med Date: 2002-08-15 Impact factor: 91.245
Authors: Michael M Chen; Florence Roufosse; Sa A Wang; Srdan Verstovsek; Sandy R Durrani; Marc E Rothenberg; Thanai Pongdee; Joseph Butterfield; Timothy Lax; Michael E Wechsler; Miguel L Stein; Princess U Ogbogu; Basil M Kahwash; Sameer K Mathur; Dagmar Simon; Praveen Akuthota; Nicole Holland; Lauren Wetzler; JeanAnne M Ware; Canting Guo; Michael P Fay; Paneez Khoury; Amy D Klion; Bruce S Bochner Journal: J Allergy Clin Immunol Pract Date: 2022-02-15
Authors: Susanne Radonjic-Hoesli; Peter Valent; Amy D Klion; Michael E Wechsler; Hans-Uwe Simon Journal: Annu Rev Pharmacol Toxicol Date: 2014-10-17 Impact factor: 13.820