Dearden C E, Matutes E, Cazin B, Tjønnfjord G E, Parreira A, Nomdedeu B, Leoni P, Clark F J, Radia D, Rassam S M, Roques T, Ketterer N, Brito-Babapulle V, Dyer M J, Catovsky D
Royal Marsden NHS Trust, London, United Kingdom.
Blood. 2001 Sep 15;98(6):1721-6. doi: 10.1182/blood.v98.6.1721.
T-cell prolymphocytic leukemia (T-PLL) is a chemotherapy-resistant malignancy with a median survival of 7.5 months. Preliminary results indicated a high remission induction rate with the human CD52 antibody, CAMPATH-1H. This study reports results in 39 patients with T-PLL treated with CAMPATH-1H between March 1993 and May 2000. All but 2 patients had received prior therapy with a variety of agents, including 30 with pentostatin; none achieved complete remission (CR). CAMPATH-1H (30 mg) was administered intravenously 3 times weekly until maximal response. The overall response rate was 76% with 60% CR and 16% partial remission (PR). These responses were durable with a median disease-free interval of 7 months (range, 4-45 months). Survival was significantly prolonged in patients achieving CR compared to PR or no response (NR), including one patient who survived 54 months. Nine patients remain alive up to 29 months after completing therapy. Seven patients received high-dose therapy with autologous stem cell support, 3 of whom remain alive in CR 5, 7, and 15 months after autograft. Stem cell harvests in these patients were uncontaminated with T-PLL cells as demonstrated by dual-color flow cytometry and polymerase chain reaction. Four patients had allogeneic stem cell transplants, 3 from siblings and 1 from a matched unrelated donor. Two had nonmyeloablative conditioning. Three are alive in CR up to 24 months after allograft. The conclusion is that CAMPATH-1H is an effective therapy in T-PLL, producing remissions in more than two thirds of patients. The use of stem cell transplantation to consolidate responses merits further study.
T 细胞幼淋巴细胞白血病（T-PLL）是一种对化疗耐药的恶性肿瘤，中位生存期为 7.5 个月。初步结果表明，人 CD52 抗体 CAMPATH-1H 具有较高的缓解诱导率。本研究报告了 1993 年 3 月至 2000 年 5 月期间 39 例接受 CAMPATH-1H 治疗的 T-PLL 患者的结果。除 2 例患者外，所有患者均曾接受过多种药物的前期治疗，其中 30 例接受过喷司他丁治疗；均未实现完全缓解（CR）。CAMPATH-1H（30mg）每周静脉注射 3 次，直至达到最大反应。总缓解率为 76%，其中 60%为 CR，16%为部分缓解（PR）。这些缓解持续时间长，无病间隔期中位数为 7 个月（范围 4 - 45 个月）。与 PR 或无反应（NR）的患者相比，达到 CR 的患者生存期显著延长，其中 1 例患者存活了 54 个月。9 例患者在完成治疗后存活长达 29 个月。7 例患者接受了自体干细胞支持的大剂量治疗，其中 3 例在自体移植后 5、7 和 15 个月仍存活于 CR 状态。双色流式细胞术和聚合酶链反应证明，这些患者的干细胞采集未被 T-PLL 细胞污染。4 例患者接受了异基因干细胞移植，3 例来自同胞，1 例来自匹配的无关供体。2 例采用了非清髓性预处理。3 例在同种异体移植后存活于 CR 状态长达 24 个月。结论是 CAMPATH-1H 是 T-PLL 的有效治疗方法，能使超过三分之二的患者获得缓解。使用干细胞移植巩固反应值得进一步研究。
