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news.Researchers from Leeds General Infirmary have reported clinical study data supporting the use of alemtuzumab as a treatment for chronic lymphocytic leukemia.
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The study, details of which have been published in the Journal of Clinical Oncology, showed that 84% of patients who had no detectable traces of chronic lymphocytic leukemia (CLL) after receiving alemtuzumab had survived for at least five years.
The results indicate the complete elimination of detectable diseased cells in patients with CLL is associated with a prolonged overall and treatment free survival. Alemtuzumab, marketed as MabCampath in Europe and as CamPath in the US, is the first, and only, monoclonal antibody approved for the treatment of CLL.
“This study shows that it is possible to achieve responses when there is no detectable disease in patients with relapsed/refractory CLL and that this appears to extend the lives of most CLL patients beyond five years,” said Dr Peter Hillmen from Leeds General Infirmary. “The introduction of alemtuzumab as a cancer therapy has had a positive impact and improves overall survival in refractory CLL. The success in achieving MRD negative remissions in this heavily pre-treated group of patients is one of the essential steps towards our long-term goal of curing CLL,” he explained.
The 18 patients, 20% of the population, who achieved the minimal residual disease-free endpoint after receiving alemtuzumab had previously failed to respond or relapsed after receiving chemotherapy for their disease. CLL patients who relapse from or are refractory to chemotherapy have the poorest prognosis with a median survival of 10 months. It was this group of patients who were sampled for the study.
Minimal residual disease (MRD) refers to the presence of leukemia cells in the bone marrow of patients in complete remission. Several retrospective and prospective studies indicate that analysis of MRD has prognostic value. Low levels or absence of MRD in the bone marrow after induction therapy are associated with positive prognosis.
The National Cancer Institute who sponsored the research, define a complete response to therapy as allowing for up to 30% of morphologically normal lymphocytes in the bone marrow, and of these cells there can be up to five percent that are CLL cells. This five percent is thought to be responsible for the relapse of the disease eventually observed in patients with CLL.
The encouraging findings were said to warrant further investigation in a larger population.