Cellular immune reconstitution after subcutaneous alemtuzumab (anti-CD52 monoclonal antibody, CAMPATH-1H) treatment as first-line therapy for B-cell chronic lymphocytic leukaemia
Abstract
Little information is available on long-term immune reconstitution after therapy with alemtuzumab in B-CLL patients. We present long-term follow-up data for blood lymphocyte subsets analysed by flow cytometry in previously untreated B-CLL patients who received alemtuzumab subcutaneously as first-line therapy. All lymphoid subsets were significantly (P<0.001) and profoundly reduced; the median end-of-treatment counts for CD4(+), CD8(+), CD3(-)56(+) (natural killer (NK)), CD3(+)56(+) (NK-T) and CD19(+)5(-) (normal B) cells were 43, 20, 4, 1 and 8 cells/microl, respectively. The median cell count of all subsets remained at <25% of the baseline values for >9 months post-treatment. CD4(+) and CD8(+) levels in blood had reached >100 cells/microl in >50% of the patients at 4 months after the end of treatment. One patient had a cytomegalovirus reactivation and one patient developed Pneumocystis carinii pneumonia during therapy. No opportunistic or other major infections were recorded during unmaintained, long-term follow-up. There was no correlation between the cumulative dose of alemtuzumab and the severity or length of immunosuppression. CD52(-) T-cell subsets occurred during the treatment and comprised >80% of all CD4(+) and CD8(+) cells in the blood at the end of therapy. These subpopulations declined gradually during unmaintained follow-up. The relationship between these observations and the safety/antitumour effects of alemtuzumab is discussed.
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TA has been described only rarely when alemtuzumab is administered for rheumatoid arthritis, blood cancers, or transplantation, suggesting a disease-specific and/or genetic background effect.
“Interestingly, TA has been described only rarely when alemtuzumab is administered for rheumatoid arthritis [32], blood cancers [33], or transplantation [34], suggesting a disease specific and/or genetic background effect.”
From 2019 European Thyroid Association Guidelines on the Management of Thyroid Dysfunction following Immune Reconstitution Therapy (2019) · cites this paper as [33]
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- Authors
- Lundin, J., Porwit-MacDonald, A., Rossmann, E. D., Karlsson, C., Edman, P., Rezvany, M. R., Kimby, E., Österborg, A., & Mellstedt, H.
- Affiliations
- Karolinska University Hospital (SE)
- Corresponding author
- Österborg, A
- Venue
- Leukemia
- Published
- 2004-01-22
- Volume
- 18
- Issue
- 3
- Pages
- 484-490
- ISSN
- 0887-6924 (ISSN-L)
- 1476-5551
- OpenAlex
- W2012630504
- Cited by
- 118
- References
- 25
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 6 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 2 · 2016: 4 · 2015: 1 · 2014: 5 · 2012: 5
- FWCI
- 8.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Leukemia (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Cancerfonden
- Karolinska Institutet
- Cancerföreningen i Stockholm
- Topics
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Immunodeficiency and Autoimmune Disorders
- Keywords
- alemtuzumab, B-cell chronic lymphocytic leukaemia, immune reconstitution, CD52, anti-CD52 monoclonal antibody, subcutaneous administration, CD4+ T cells, CD8+ T cells, natural killer cells, NKT cells, CD19+ B cells, immunosuppression, cytomegalovirus reactivation, Pneumocystis carinii pneumonia, long-term follow-up, first-line therapy
- MeSH terms
- Alemtuzumab, Adult, Aged, Antibodies, Monoclonal, Antibodies, Neoplasm, Antineoplastic Agents, Follow-Up Studies, Humans, Immunity, Cellular, Injections, Subcutaneous, Killer Cells, Natural, Middle Aged, Remission Induction, T-Lymphocytes, Leukemia, Lymphocytic, Chronic, B-Cell, Antigens, CD, Case-Control Studies, Immunophenotyping, Treatment Outcome, Antibodies, Monoclonal, Humanized
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