The Outcome of HyperCVAD Combined with Alemtuzumab for the Treatment of Aggressive T-Cell and NK-Cell Neoplasms.
We report our experience in using six cycles of hyperCVAD in combination with alemtuzumab for the treatment of aggressive T-cell and NK/T-cell neoplasms. Seven females and six males with the median age of 41 (range 18–60) diagnosed with T-cell acute lymphoblastic lymphoma and peripheral T-cell...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier Ltd.
2011
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| Subjects: | |
| Online Access: | http://ir.unimas.my/id/eprint/12281/ http://ir.unimas.my/id/eprint/12281/7/A%20randomized%20double%20blind%20control%20trial%20comparing%20filgrastim%20%28abstract%29.pdf |
| Summary: | We report our experience in using six cycles of
hyperCVAD in combination with alemtuzumab for the
treatment of aggressive T-cell and NK/T-cell neoplasms.
Seven females and six males with the median age of 41
(range 18–60) diagnosed with T-cell acute lymphoblastic
lymphoma and peripheral T-cell and NK/T-cell neoplasms
(nPTCL = 6, nT-cell ALL = 3, nNK/T-cell neoplasms = 4) from
2006 to 2008 were treated with alemtuzumab–hyperCVAD
regimen. A total of nine patients (69%) responded to the
regimen, with seven achieved complete remission and two
achieved partial remission. The median progression free
survival and overall survival duration among the responders
with complete remission were 12.9 and 24.9 months
respectively. The incidence of relapse among the responders
was 44% and the overall survival rate was 23%. Only
four (31%) patients completed the six cycles of alemtuzumab–
hyperCVAD. Others were stopped earlier due to
progressive disease (n = 2), cytomegalovirus (CMV)
reactivation and/or disease (n = 3), death not due to disease (n = 2), and patient’s refusal to continue alemtuzumab (n = 2). The incidence of death not due to disease, CMV reactivation and recurrent CMV reactivation were 50, 50 and 17%, respectively. This study shows that alemtuzumab in combination with hyperCVAD regimen is a feasible regimen but with high toxicity. The toxicity might be reduced with the incorporation of filgrastim and use of
valganciclovir as CMV prophylaxis. |
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