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Blood, 15 August 2004, Vol. 104, No. 4, pp. 948-955. Prepublished online as a Blood First Edition Paper on April 15, 2004; DOI 10.1182/blood-2004-02-0593. This Article Full Text Full Text (PDF) All Versions of this Article: 2004-02-0593v1 104/4/948    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Hale, G. Articles by Hillmen, P. Search for Related Content PubMed PubMed Citation Articles by Hale, G. Articles by Hillmen, P. Related Collections Immunobiology Neoplasia Immunotherapy Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Blood concentrations of alemtuzumab and antiglobulin responses in patients with chronic lymphocytic leukemia following intravenous or subcutaneous routes of administration Geoff Hale, Peppy Rebello, Lee R. Brettman, Chris Fegan, Ben Kennedy, Eva Kimby, Mike Leach, Jeanette Lundin, Håkan Mellstedt, Paul Moreton, Andy C. Rawstron, Herman Waldmann, Anders Osterborg, and Peter Hillmen From the Sir William Dunn School of Pathology, University of Oxford, Oxford, United Kingdom; Millennium Pharmaceuticals, Cambridge, MA; the Department of Haematology, Heartlands Hospital, Birmingham, United Kingdom; the Department of Haematology, Leeds General Infirmary, United Kingdom; the Department of Hematology, Huddinge Hospital, Sweden; the Department of Haematology, Stobhill Hospital, Glasgow, United Kingdom; and the Departments of Hematology and Oncology, Karolinska Hospital, Stockholm, Sweden. Alemtuzumab is a humanized anti-CD52 antibody licensed for refractory B-cell chronic lymphocytic leukemia (B-CLL), when given intravenously at 30 mg thrice weekly. However, the intravenous route is associated with infusion-related reactions and is inconvenient. We measured blood concentrations in 30 relapsed patients treated with intravenous alemtuzumab and in 20 patients from a previously untreated group who received similar doses subcutaneously. Highest trough samples in the intravenous group were less than 0.5 µg/mL to 18.3 µg/mL (mean 5.4 µg/mL). The cumulative dose required to reach 1.0 µg/mL was 13 mg to 316 mg (mean 90 mg). Higher blood concentrations correlated with the achievement of better clinical responses and minimal residual disease. The highest measured concentrations in the subcutaneous group were similar (0.6 µg/mL to 24.8 µg/mL, mean 5.4 µg/mL). However, the cumulative dose to reach 1.0 µg/mL was higher: 146 mg to 1106 mg (mean 551 mg). No antiglobulin responses were detected in 30 patients given intravenous alemtuzumab whereas 2 of 32 patients given subcutaneous alemtuzumab made substantial anti-idiotype responses. Thus, subcutaneous alemtuzumab achieved concentrations similar to those for intravenous alemtuzumab, although with slightly higher cumulative doses. Subcutaneous alemtuzumab is more convenient and better tolerated but may be associated with some patients forming anti–alemtuzumab antibodies, particularly those patients who were previously untreated. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: T. Elter, J. Kilp, P. Borchmann, H. Schulz, M. Hallek, and A. Engert Pharmacokinetics of alemtuzumab in combination with fludarabine in patients with relapsed or refractory B-cell chronic lymphocytic leukemia Haematologica, January 1, 2009; 94(1): 150 - 152. [Full Text] [PDF] M. G. Bernengo, P. Quaglino, A. Comessatti, M. Ortoncelli, M. Novelli, F. Lisa, and M. T. Fierro Low-dose intermittent alemtuzumab in the treatment of Sezary syndrome: clinical and immunologic findings in 14 patients Haematologica, June 1, 2007; 92(6): 784 - 794. [Abstract] [Full Text] [PDF] B. L. Abbott Chronic Lymphocytic Leukemia: Recent Advances in Diagnosis and Treatment Oncologist, January 1, 2006; 11(1): 21 - 30. [Abstract] [Full Text] [PDF] B. Keymeulen, E. Vandemeulebroucke, A. G. Ziegler, C. Mathieu, L. Kaufman, G. Hale, F. Gorus, M. Goldman, M. Walter, S. Candon, et al. Insulin Needs after CD3-Antibody Therapy in New-Onset Type 1 Diabetes N. Engl. J. Med., June 23, 2005; 352(25): 2598 - 2608. [Abstract] [Full Text] [PDF]

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