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Long term follow up of an Alemtuzumab (CAMPATH-1H) containing reduced intensity Allogeneic Transplant Regimen for Non-Hodgkins Lymphoma (NHL)

Reviewer: Julie Draznin Maltzman, MD
OncoLink
Last Modified: December 8, 2002

Presenter: Emma Morris
Presenter's Affiliation: UK Collaborative Group, United Kingdom
Type of Session: Scientific

Background

• Campath is an antibody that targets CD 52 which is a T cell marker.
• Campath has been studied in induction therapies for myeloablative transplants.
• This study looked at Campath as additional therapy for reduced intensity allogeneic stem cell therapy for NHL.

Materials and Methods

• 93 total pts were enrolled with a predominance of men
• Median pt age was 43 years
• 46 pts had low grade or indolent lymphoma and 47 had intermediate or high grade lymphoma.
• The median number of previous therapies for all pts was 3.
• Campath was given from 9 days prior to transplant to day minus 4. A conditioning regimen of Fludarabine and Melphalan was used.
• Cyclosporin was used as GVH prophylaxis.

Results

• 91 of the 93 pts had full engraftment. One graft rejection was seen and one death occured prior to engraftment.
• 75% of the pts experienced no GVHD. 11% had grade I GVHD, and only 4% had grade III-IV GVHD.
• Treatment related mortality at day 100 was 13% and at one year 17%.
• After 26 months of follow up overall survival was 64% for all.
• Overall survival for low grade lymphoma was 80% whereas for high grade disease survival was 33%.

Author's Conclusions

• Campath use for in vivo T cell depletion reduces the incidence and severity of GVHD while getting 80% overall survival rates for low grade indolent lymphoma.

Clinical/Scientific Implications

These data imply that bone marrow T cell depletion can be adequately and efficiently done with Campath induction therapy. This may have cost and time saving implications for T cell depleted bone marrows. Further studies of this agent are indicated.

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