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Pretreated Chronic Lymphocytic Leukemia: Use of Alemtuzumab

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Methods of Cancer Diagnosis, Therapy, and Prognosis

Part of the book series: Methods of Cancer Diagnosis, Therapy and Prognosis ((HAYAT,volume 6))

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Abstract

Alemtuzumab is a geno-technologically produced humanized monoclonal IgG1-kappa antibody, which binds specifically to the 21–28 kD glycoprotein CD52 on the surface of lymphocytes. The CD52 antigen consists of 12 amino acid residues and an N-terminal bound oligosaccharid complex which is responsible for membrane anchoring. The function of CD52 in the various expressing cell types is not fully known. CD52 is found on normal and neoplastic T- and B-cells. It is located very densely on the cell surface, with an estimated 450,000 copies of the CD52 molecule per cell (Hale 2001). CD52 expression is found in B-cell lymphoproliferative diseases (all cases of chronic lymphocytic leukemia [B-CLL], in most cases of low grade lymphomas, hairy cell leukemia, diffuse large B-cell lymphomas, large-cell anaplastic and lymphoblastic lymphomas). Furthermore, it is found in many T-cell lymphomas, such as, of highest clinical relevance, on T-cell prolymphocytic leukemia (T-PLL) and peripheral T-cell lyphomas (PTCL). Hematopoietic stem cells or progenitor cells do not express CD52 on their surface, and cells of the myeloid lineage are generally CD52 negative, with the exception of eosinophilic granulocytes and mature monocytic cells/macrophages (Dyer 2005). Finally, CD52 expression is found on epithelial cells of epidymis, vas deferens and vesiculi seminales. It is also stated in this connection that alemtuzumab therapy appears not to compromise ferti­lity. To mention the mechanisms of efficacy of therapeutically used alemtuzumab, there are three actions leading to the destruction of the target cells: Antibody-dependent cellular cytotoxicity Direct, complement-dependent cytotoxicity Direct induction of apoptosis

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Acknowledgments

Further contributors to this work included the following: G. Gastl (Innsbruck); A Walder (Lienz); FX Schmid (Bregenz); K. Eigenberger (Vienna). G. Hopfinger (Vienna); R. Greil (Salzburg), A. Zabernigg (Kufstein).

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  1. Department of Internal Medicine/Oncology, Academic Natters Hospital, University Hospital of Innbsruck, In der Stille 20, A-6161, Natters, Austria

    Michael Fiegl

  2. Department of Internal Medicine/Oncology, Academic Natters Hospital, University Hospital of Brno, Czech Republik, In der Stille 20, A-6161, Natters, Austria

    Jiri Mayer

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  1. Dept. Biological Sciences, Kean University, Union, 07083, U.S.A.

    M. A. Hayat

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Fiegl, M., Mayer, J. (2010). Pretreated Chronic Lymphocytic Leukemia: Use of Alemtuzumab. In: Hayat, M. (eds) Methods of Cancer Diagnosis, Therapy, and Prognosis. Methods of Cancer Diagnosis, Therapy and Prognosis, vol 6. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2918-8_29

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