Damlaj Moussab, Sulai Nanna H, Oliveira Jennifer L, Ketterling Rhett P, Hashmi Shahrukh, Witzig Thomas, Nowakowski Grzegorz, Call Timothy G, Shanafelt Tait D, Ding Wei, Hogan William J, Litzow Mark R, Patnaik Mrinal M
Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
Clin Lymphoma Myeloma Leuk. 2015 Nov;15(11):699-704. doi: 10.1016/j.clml.2015.07.643. Epub 2015 Aug 5.
We conducted a single-center retrospective analysis to determine the impact of the anti-CD52 monoclonal antibody alemtuzumab including route of administration compared to non-alemtuzumab-containing regimens in T-prolymphocytic leukemia (T-PLL).
The study was a retrospective analysis of a consecutive cohort of adult patients diagnosed with T-PLL at Mayo Clinic Rochester from January 1, 1997, through September 30, 2014.
A total of 41 patients were diagnosed with T-PLL per the World Health Organization 2008 classification. The median age was 66 years, and 23 (56%) were male. After a median follow-up of 18 months (range, 0.4-66.1 months), 32 patients (78%) had died, with a median overall survival of 16.9 months. Approximately half the cohort was treated with alemtuzumab, almost exclusively after 2004. Median survival for patients receiving intravenous alemtuzumab-based therapy was 40.5 versus 10.3 months for all other therapies (P = .0004). A significant survival difference between intravenous versus subcutaneous alemtuzumab administration of 40.5 versus 13.7 months was noted (P = .0014). Only 4 (14%) of 28 patients aged < 70 years underwent hematopoietic stem cell transplantation, with a median survival after transplantation of 4 months.
In this large series of T-PLL patients treated at a single tertiary-care center, we confirmed the prior observation of the superiority of intravenous alemtuzumab over other therapies. Hematopoietic stem cell transplantation was feasible in a minority of potentially eligible patients. Early transplant referral should be considered for all eligible patients.
我们进行了一项单中心回顾性分析，以确定抗CD52单克隆抗体阿仑单抗（包括给药途径）与不含阿仑单抗的方案相比，在T-原淋巴细胞白血病（T-PLL）中的影响。
本研究是对1997年1月1日至2014年9月30日在罗切斯特梅奥诊所确诊为T-PLL的成年患者连续队列进行的回顾性分析。
根据世界卫生组织2008年分类，共有41例患者被诊断为T-PLL。中位年龄为66岁，23例（56%）为男性。中位随访18个月（范围0.4 - 66.1个月）后，32例患者（78%）死亡，中位总生存期为16.9个月。大约一半的队列接受了阿仑单抗治疗，几乎全部在2004年之后。接受基于静脉注射阿仑单抗治疗的患者中位生存期为40.5个月，而所有其他治疗为10.3个月（P = .0004）。静脉注射与皮下注射阿仑单抗的生存期有显著差异，分别为40.5个月和13.7个月（P = .0014）。28例年龄<70岁的患者中只有4例（14%）接受了造血干细胞移植，移植后的中位生存期为4个月。
在这个由单一三级医疗中心治疗的大量T-PLL患者系列中，我们证实了先前观察到的静脉注射阿仑单抗优于其他治疗的结果。造血干细胞移植在少数潜在符合条件的患者中是可行的。应考虑对所有符合条件的患者进行早期移植转诊。
