Authors: Nicola Gökbuget Dieter Hoelzer
Publish Date: 2003/11/26
Volume: 83, Issue: 4, Pages: 201-205
Abstract
After rapid improvement of treatment results in adult acute lymphoblastic leukemia ALL from less than 10 to 30–40 in the past decades more recently stagnation has been observed In addition a borderline for further intensification of chemotherapy appears to be reached in adult ALL patients New preferably nonchemotherapy approaches are therefore urgently required One of those is targeted therapy with monoclonal antibodies MoAbs ALL blast cells express a variety of specific antigens which may serve as targets such as CD19 CD20 CD22 CD33 and CD52 Published results of MoAbs in ALL are reviewed Most experience is available for antiCD20 rituximab which led to a significant improvement of the outcome in Bcell nonHodgkin’s lymphoma NHL In ALL rituximab is combined with chemotherapy mainly in mature BALL and Burkitt’s lymphoma and preliminary results are promising In the future studies will also be done in Bprecursor ALL Another promising Bcell antibody is antiCD22 Several CD19 MoAbs were also tested in phase I studies However results are not conclusive and these MoAbs are not generally available Far less experience with MoAb therapy is available for TALL but clinical studies are on the way with antiCD52 and antiCD25 in adult Tcell leukemia/lymphoma Overall it can be stated that MoAb therapy in ALL is a promising treatment approach Monotherapy with MoAbs in relapsed ALL occasionally led to responses but higher effectivity can be expected from a combination with chemotherapy and treatment in the state of minimal residual disease Welldesigned studies and joint efforts are required to explore optimal combinations timing and dosage of MoAb therapy in ALL
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