Alemtuzumab in chronic lymphocytic leukaemia, other lymphoproliferative disease and autoimmune disorders

Alemtuzumab is a humanized IgG1 antibody targetting the CD52 antigen which is primarily present on normal and neoplastic lymphoid cells. In a number of studies, its therapeutic efficacy was shown in the treatment of certain lymphomas including chronic lymphocytic leukaemia (B-CLL). In this indication, it was registered in 2001 with patients refractory towards fludarabine. In 2007, it was also registered as first line therapy in B-CLL patients, for whom fludarabine combination chemotherapy is not appropriate. Alemtuzumab is especially beneficial in B-CLL with 17p deletion, by which its otherwise unfavourable course of disease is improved. In this review, the role of alemtuzumab as antineoplastic tool in lymphoid malignancies and as immunosuppressive tool in autoimmune diseases and in the setting of transplantation is described. Furthermore, results from the Austrian-Czech registry on alemtuzumab therapy in B-CLL are updated.