Dose modification of alemtuzumab in combination with dexamethasone, cytarabine, and cisplatin in patients with relapsed or refractory peripheral T-cell lymphoma

Analysis of efficacy and toxicity

Seok Jin Kim, Kihyun Kim, Yong Park, Byung Soo Kim, Jooryung Huh, Young Hae Ko, Keunchil Park, Cheolwon Suh, Won Seog Kim

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Background There is still no consensus on the role of alemtuzumab as a salvage therapy for relapsed or refractory peripheral T-cell lymphoma (PTCL). We studied the efficacy and toxicity of combination treatment of alemtuzumab, dexamethasone, cytarabine, and cisplatin (A-DHAP) for treating PTCL. Methods We enrolled 24 patients with relapsed or refractory PTCL. Each patient received DHAP plus alemtuzumab every 3 weeks for up to three cycles. Two alemtuzumab dosages of 70 mg or 40 mg were used per cycle. After A-DHAP treatment, the responders underwent autologous stem cell transplantation. Results The overall response rate was 50.0% (12 of 24 patients), including five complete responders and seven partial responders. Analysis of the responses according to histological type showed a higher objective response rate for PTCL-unspecified (69.2%: four complete responders, five partial responders) than for extranodal NK/T cell lymphoma (12.5%, one partial responder). The median overall survival (OS) after enrollment was 6.0 months (95% confidence interval: 4.20-7.80 months), and the median response duration of responders was 2.93 months (95% confidence interval: 0.93-4.93 months). The overall response rate and OS did not differ significantly according to the dosage of alemtuzumab (70 mg vs. 40 mg, P>0.05). The most frequent side effect was grade 3/4 leukopenia. Nondisease- related death occurred more frequently in patients who received 70 mg of alemtuzumab. Conclusions The combination of alemtuzumab plus DHAP might be effective salvage chemotherapy for PTCL, and 40 mg of alemtuzumab appears to be a more tolerable dosage when used in combination with DHAP.

Original languageEnglish
Pages (from-to)368-375
Number of pages8
JournalInvestigational New Drugs
Volume30
Issue number1
DOIs
Publication statusPublished - 2012 Feb 1

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Peripheral T-Cell Lymphoma
Cytarabine
Dexamethasone
Cisplatin
Extranodal NK-T-Cell Lymphoma
Confidence Intervals
Salvage Therapy
alemtuzumab
Leukopenia
Stem Cell Transplantation
Survival Rate
Drug Therapy
Survival

Keywords

  • Alemtuzumab
  • Salvage chemotherapy
  • T-cell lymphoma
  • Toxicity

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)
  • Oncology

Cite this

Dose modification of alemtuzumab in combination with dexamethasone, cytarabine, and cisplatin in patients with relapsed or refractory peripheral T-cell lymphoma : Analysis of efficacy and toxicity. / Kim, Seok Jin; Kim, Kihyun; Park, Yong; Kim, Byung Soo; Huh, Jooryung; Ko, Young Hae; Park, Keunchil; Suh, Cheolwon; Kim, Won Seog.

In: Investigational New Drugs, Vol. 30, No. 1, 01.02.2012, p. 368-375.

Research output: Contribution to journalArticle

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abstract = "Background There is still no consensus on the role of alemtuzumab as a salvage therapy for relapsed or refractory peripheral T-cell lymphoma (PTCL). We studied the efficacy and toxicity of combination treatment of alemtuzumab, dexamethasone, cytarabine, and cisplatin (A-DHAP) for treating PTCL. Methods We enrolled 24 patients with relapsed or refractory PTCL. Each patient received DHAP plus alemtuzumab every 3 weeks for up to three cycles. Two alemtuzumab dosages of 70 mg or 40 mg were used per cycle. After A-DHAP treatment, the responders underwent autologous stem cell transplantation. Results The overall response rate was 50.0{\%} (12 of 24 patients), including five complete responders and seven partial responders. Analysis of the responses according to histological type showed a higher objective response rate for PTCL-unspecified (69.2{\%}: four complete responders, five partial responders) than for extranodal NK/T cell lymphoma (12.5{\%}, one partial responder). The median overall survival (OS) after enrollment was 6.0 months (95{\%} confidence interval: 4.20-7.80 months), and the median response duration of responders was 2.93 months (95{\%} confidence interval: 0.93-4.93 months). The overall response rate and OS did not differ significantly according to the dosage of alemtuzumab (70 mg vs. 40 mg, P>0.05). The most frequent side effect was grade 3/4 leukopenia. Nondisease- related death occurred more frequently in patients who received 70 mg of alemtuzumab. Conclusions The combination of alemtuzumab plus DHAP might be effective salvage chemotherapy for PTCL, and 40 mg of alemtuzumab appears to be a more tolerable dosage when used in combination with DHAP.",
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AU - Kim, Kihyun

AU - Park, Yong

AU - Kim, Byung Soo

AU - Huh, Jooryung

AU - Ko, Young Hae

AU - Park, Keunchil

AU - Suh, Cheolwon

AU - Kim, Won Seog

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AB - Background There is still no consensus on the role of alemtuzumab as a salvage therapy for relapsed or refractory peripheral T-cell lymphoma (PTCL). We studied the efficacy and toxicity of combination treatment of alemtuzumab, dexamethasone, cytarabine, and cisplatin (A-DHAP) for treating PTCL. Methods We enrolled 24 patients with relapsed or refractory PTCL. Each patient received DHAP plus alemtuzumab every 3 weeks for up to three cycles. Two alemtuzumab dosages of 70 mg or 40 mg were used per cycle. After A-DHAP treatment, the responders underwent autologous stem cell transplantation. Results The overall response rate was 50.0% (12 of 24 patients), including five complete responders and seven partial responders. Analysis of the responses according to histological type showed a higher objective response rate for PTCL-unspecified (69.2%: four complete responders, five partial responders) than for extranodal NK/T cell lymphoma (12.5%, one partial responder). The median overall survival (OS) after enrollment was 6.0 months (95% confidence interval: 4.20-7.80 months), and the median response duration of responders was 2.93 months (95% confidence interval: 0.93-4.93 months). The overall response rate and OS did not differ significantly according to the dosage of alemtuzumab (70 mg vs. 40 mg, P>0.05). The most frequent side effect was grade 3/4 leukopenia. Nondisease- related death occurred more frequently in patients who received 70 mg of alemtuzumab. Conclusions The combination of alemtuzumab plus DHAP might be effective salvage chemotherapy for PTCL, and 40 mg of alemtuzumab appears to be a more tolerable dosage when used in combination with DHAP.

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