BACKGROUND.In previous studies, alemtuzumab demonstrated considerable activity in patients with previously treated B‐cell chronic lymphocytic leukemia (CLL), including fludarabine‐refractory disease. In this retrospective study, the authors evaluated the benefit of alemtuzumab monotherapy in unselected patients with advanced, previously treated CLL who received treatment in the routine clinical setting.METHODS.Data were collected from 115 consecutive patients who received alemtuzumab therapy at 25 participating centers in Austria. Patients received a median of 3 prior lines of therapy (range, 1–11 prior lines of therapy), and 59% had fludarabine‐refractory disease. Alemtuzumab was administered intravenously or subcutaneously with a planned schedule of 30 mg 3 times per week for up to 12 weeks. Patients received valacyclovir and trimethoprim/sulfamethoxazole for antiinfective prophylaxis.RESULTS.The overall response rate was 23%, with complete responses achieved in 5% of patients. Stable disease (SD) was achieved in 36% of patients. After a median follow‐up of 17.5 months, the median overall survival (OS) was 20.2 months for all patients. A multivariate Cox regression analysis that included pretreatment baseline characteristics, response to therapy, and cumulative dose of alemtuzumab indicated that bulky lymphadenopathy, the administration of ≥3 previous therapies, and lack of response to alemtuzumab remained significant independent risk factors for inferior OS. The median OS had not been reached for responding patients. The median OS was 29.5 months for patients with SD and 10.8 months for patients with progressive disease.CONCLUSIONS.The broad use of alemtuzumab in the routine clinical practice setting is feasible and active in unselected patients with pretreated CLL, and the current results confirmed the activity and safety of this agent, as reported in previously published clinical studies. Cancer 2006. © 2006 American Cancer Society.

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Eighteen euthyroid patients with progressive malignant exophthalmos, of whom 16 had been treated by other forms of therapy, were treated with large therapeutic doses of radioactive iodine in an effort to ablate their thyroid glands. In four of the patients no functioning thyroid tissue could be demonstrated; in the others thyroid tissue can still be demonstrated with 5 mc doses of 131I preceded by thyrotrophin. In all patients, marked improvement of the infiltrative changes of ophthalmopathy resulted. Proptosis improved but in none of them did it regress completely to normal. The doses of radioactive iodine required to destroy thyroid remnants were much larger than the doses employed in the treatment of hyperthyroidism. It is suggested that the thyroid gland plays an important part in the complex problem of progressive exophthalmos and the presence of LATS, although its precise role remains to be determined.

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