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Level of expression of target antigens CD20 and CD52 in relation to the therapy with monoclonal antibodies in patients with chronic lymphocytic leukemia


Authors: M. Klabusay;  M. Pevná;  V. Nováková;  Y. Brychtová;  J. Mayer
Authors‘ workplace: Interní hematoonkologická klinika, Lékařská fakulta Masarykovy univerzity a Fakultní nemocnice Brno
Published in: Transfuze Hematol. dnes,15, 2009, No. 1, p. 17-22.
Category: Comprehensive Reports, Original Papers, Case Reports

Overview

Introduction:
The treatment with monoclonal antibodies represents an effective treatment of chronic lymphoproliferative diseases. Most often, rituximab (anti-CD20 monoclonal antibody) and alemtuzumab (anti-CD52 monoclonal antibody) are used in the treatment of CLL. Based on in vitro tests and clinical response of malignancies with high level of antigen expression (e.g. CD20 in follicular lymphoma or CD52 in T-prolymphocytic leukemia) it was suggested that the level of target antigen expression is one of the important factors for therapeutic response to monoclonal antibodies. In this article, we describe the patients with diagnosis of CLL who were treated at our Department and in whom the levels of expression of CD20 and CD52 antigens were determined.

Patients and methods:
Samples of peripheral blood of 8 patients were analyzed by quantitative flow cytometry. The expression of CD20 and CD52 antigens was expressed in MESF units. Patients were treated with related monoclonal antibodies and the response was evaluated according to NCI-WG criteria.

Results:
In the group of patients with CD20 expression below 43 000 MESF (median value determined for CLL in our previous work) either the therapeutic response was not reached or it was short lasting. In patients with CD20 expression above this level, three of them reached therapeutic response. Of the three patients with determined CD52 expression, only the patient with CD52 above 445 000 MESF (median value for CLL) reached the complete response.

Conclusions:
Because of small pilot group of patients and complexity of the problem, we cannot draw any definitive conclusions supported by statistical analysis. However, the possible relation of levels of target antigens with the therapeutic outcome of treatment with particular monoclonal antibody will require further research.

Key words:
chronic lymphocytic leukemia, quantitative flow cytometry, CD20, CD52, rituximab, alemtuzumab


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Haematology Internal medicine Clinical oncology
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