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Minimal residual disease elimination by consolidation
therapy with alemtuzumab
Susan O’Brien
The University of Texas, MD Anderson Cancer Center, Houston,
Texas, USA
Chronic lymphocytic leukemia (CLL) is one of the most common
hematologic malignancies in the developed world. In recent decades,
the development of novel therapies has greatly expanded the range
of treatment options, including monoclonal antibodies. New methods
for detecting residual disease have also been developed and are
being used to assess the depth of clinical response achieved with
novel treatment strategies.
One such strategy involves the use of the monoclonal antibody as
consolidation therapy to eradicate minimal residual disease (MRD)
following chemotherapeutic induction. Alemtuzumab is a humanized
monoclonal antibody that binds CD52, an antigen expressed at high
density on most normal and malignant T- and B-cell lymphocytes but
not on hematopoietic stem cells.1,2
Alemtuzumab has demonstrated consistent activity against malignant
lymphocytes in blood, marrow and the spleen. However, its activity
is limited by the presence of bulky disease (lymph nodes,
extranodal masses), which is often associated with refractory
disease. The suggestion that monoclonal antibodies, such as
alemtuzumab, might be best utilized under conditions of MRD has
prompted several trials investigating the role of alemtuzumab
following tumor debulking by chemotherapy. [>Read full article in PDF]