Phenotypic transformation of CD52(pos) to CD52(neg) leukemic T cells as a mechanism for resistance to CAMPATH-1H

R E Birhiray; G Shaw; S Guldan; D Rudolf; D Delmastro; P Santabarbara; L Brettman

doi:10.1038/sj.leu.2402471

Phenotypic transformation of CD52(pos) to CD52(neg) leukemic T cells as a mechanism for resistance to CAMPATH-1H

Leukemia. 2002 May;16(5):861-4. doi: 10.1038/sj.leu.2402471.

Authors

R E Birhiray¹, G Shaw, S Guldan, D Rudolf, D Delmastro, P Santabarbara, L Brettman

Affiliation

¹ Department of Hematology/Oncology, Marshfield Clinic, Marshfield, WI, USA.

PMID: 11986948
DOI: 10.1038/sj.leu.2402471

Abstract

Immunotherapy utilizing CAMPATH-1H for patients with chemotherapy-refractory chronic lymphocytic leukemia has yielded encouraging results with many reports of complete remission. Here we report the outcome of two patients with CD4-positive T cell prolymphocytic leukemia treated with CAMPATH-1H. Both patients responded rapidly to treatment and subsequently developed CD4 lymphopenia. One patient remained in complete remission after 14 weeks of treatment. Serial peripheral blood flow cytometry revealed that the CD52 antigen was present throughout treatment. The other patient who was initially CD52-positive, became CD52-negative after 6 weeks of treatment, and developed progressive symptoms of T cell prolymphocytic leukemia. Immunotherapy was stopped, chemotherapy proved futile, and the patient died. This change in phenotype from CD52-positive to -negative during CAMPATH-1H therapy points out a need to develop strategies for maintaining antigenic expression during monoclonal antibody therapy.

Publication types

Case Reports
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Alemtuzumab
Antibodies, Monoclonal / administration & dosage
Antibodies, Monoclonal / pharmacology*
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm / administration & dosage
Antibodies, Neoplasm / pharmacology*
Antigens, CD / analysis*
Antigens, CD / drug effects
Antigens, Neoplasm*
CD4-Positive T-Lymphocytes / drug effects
CD4-Positive T-Lymphocytes / pathology
CD52 Antigen
Drug Resistance, Neoplasm*
Fatal Outcome
Female
Glycoproteins / analysis*
Glycoproteins / drug effects
Humans
Immunophenotyping
Leukemia, Prolymphocytic / drug therapy
Leukemia, Prolymphocytic / genetics
Leukemia, Prolymphocytic / pathology*
Leukemia, Prolymphocytic, T-Cell / drug therapy
Leukemia, Prolymphocytic, T-Cell / genetics
Leukemia, Prolymphocytic, T-Cell / pathology
Lymphocyte Activation / genetics
Male
Middle Aged
Phenotype
Remission Induction

Substances

Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Antibodies, Neoplasm
Antigens, CD
Antigens, Neoplasm
CD52 Antigen
CD52 protein, human
Glycoproteins
Alemtuzumab