Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma
Abstract Cutaneous T-cell lymphomas (CTCL) have in common malignant T-lymphocyte infiltration in the skin. Low dose alemtuzumab (LDA) appears to be an effective treatment for leukemic disease, but in the absence of clinical trials, there is need for improved characterization of patients with CTCL mo...
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Nature Publishing Group
2025-04-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-025-01237-5 |
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| author | Cecilia Larocca Ai-Tram N. Bui John T. O’Malley Anita Giobbie-Hurder Marianne Tawa Jessica E. Teague Rachael A. Clark Corey Cutler Eric Jacobsen David C. Fisher Thomas S. Kupper Nicole R. LeBoeuf |
| author_facet | Cecilia Larocca Ai-Tram N. Bui John T. O’Malley Anita Giobbie-Hurder Marianne Tawa Jessica E. Teague Rachael A. Clark Corey Cutler Eric Jacobsen David C. Fisher Thomas S. Kupper Nicole R. LeBoeuf |
| author_sort | Cecilia Larocca |
| collection | DOAJ |
| description | Abstract Cutaneous T-cell lymphomas (CTCL) have in common malignant T-lymphocyte infiltration in the skin. Low dose alemtuzumab (LDA) appears to be an effective treatment for leukemic disease, but in the absence of clinical trials, there is need for improved characterization of patients with CTCL most likely to benefit. A retrospective cohort study of 38 patients with CTCL treated with LDA with at least 5 years’ follow-up data was conducted. As a surrogate for a central memory T-cell (TCM) clinical phenotype, we evaluated whether the absence of a history of papules, plaques, and tumors (PPT) predicts better global and skin response. Twenty-five (65.8%) patients responded to LDA (95% CI: 49–80%). Patients with a TCM phenotype were more than eight times as likely to achieve a CR [OR: 8.2, 95% CI: 1.2–57.6]. CR rate in the skin was 81.8% in TCM phenotype patients compared to 37.0% in patients with a history of PPT (resident memory T-cell phenotype, TRM) [OR: 7.7, 95% CI: 1.4–42.7]. Three patients experienced any infection requiring systemic intervention. LDA monotherapy can safely produce exceptional response rates in those presenting with diffuse erythema but without a history of PPT. |
| format | Article |
| id | doaj-art-1a038e1fcb2b493fbcb402f937a7560f |
| institution | OA Journals |
| issn | 2044-5385 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj-art-1a038e1fcb2b493fbcb402f937a7560f2025-08-20T02:24:26ZengNature Publishing GroupBlood Cancer Journal2044-53852025-04-011511810.1038/s41408-025-01237-5Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphomaCecilia Larocca0Ai-Tram N. Bui1John T. O’Malley2Anita Giobbie-Hurder3Marianne Tawa4Jessica E. Teague5Rachael A. Clark6Corey Cutler7Eric Jacobsen8David C. Fisher9Thomas S. Kupper10Nicole R. LeBoeuf11Harvard Medical SchoolHarvard Medical SchoolHarvard Medical SchoolDivision of Biostatistics, Department of Data Sciences, Dana-Farber Cancer InstituteDepartment of Dermatology, Brigham and Women’s HospitalDepartment of Dermatology, Brigham and Women’s HospitalHarvard Medical SchoolDepartment of Medical Oncology, Dana-Farber/Brigham and Women’s Cancer CenterDepartment of Medical Oncology, Dana-Farber/Brigham and Women’s Cancer CenterDepartment of Medical Oncology, Dana-Farber/Brigham and Women’s Cancer CenterHarvard Medical SchoolHarvard Medical SchoolAbstract Cutaneous T-cell lymphomas (CTCL) have in common malignant T-lymphocyte infiltration in the skin. Low dose alemtuzumab (LDA) appears to be an effective treatment for leukemic disease, but in the absence of clinical trials, there is need for improved characterization of patients with CTCL most likely to benefit. A retrospective cohort study of 38 patients with CTCL treated with LDA with at least 5 years’ follow-up data was conducted. As a surrogate for a central memory T-cell (TCM) clinical phenotype, we evaluated whether the absence of a history of papules, plaques, and tumors (PPT) predicts better global and skin response. Twenty-five (65.8%) patients responded to LDA (95% CI: 49–80%). Patients with a TCM phenotype were more than eight times as likely to achieve a CR [OR: 8.2, 95% CI: 1.2–57.6]. CR rate in the skin was 81.8% in TCM phenotype patients compared to 37.0% in patients with a history of PPT (resident memory T-cell phenotype, TRM) [OR: 7.7, 95% CI: 1.4–42.7]. Three patients experienced any infection requiring systemic intervention. LDA monotherapy can safely produce exceptional response rates in those presenting with diffuse erythema but without a history of PPT.https://doi.org/10.1038/s41408-025-01237-5 |
| spellingShingle | Cecilia Larocca Ai-Tram N. Bui John T. O’Malley Anita Giobbie-Hurder Marianne Tawa Jessica E. Teague Rachael A. Clark Corey Cutler Eric Jacobsen David C. Fisher Thomas S. Kupper Nicole R. LeBoeuf Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma Blood Cancer Journal |
| title | Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma |
| title_full | Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma |
| title_fullStr | Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma |
| title_full_unstemmed | Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma |
| title_short | Long-term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous T-cell lymphoma |
| title_sort | long term outcomes and clinical phenotypes associated with best response to low dose alemtuzumab in cutaneous t cell lymphoma |
| url | https://doi.org/10.1038/s41408-025-01237-5 |
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