with acetaminophen and antihistamines. It can be given as a subcutaneous injection, but the data at least in T cell prolymphocytic leukemia indicate decreased efficacy if given by the subcutaneous Rucaparib route. A small number of studies have shown a response rate of over 70% in patients with T cell PLL with CRs in the range of 4050%. Enblad et al. have studied this in 14 patients with PTCL and found an ORR of 36% including 3 CRs lasting up to 12 months. The major toxicity is immunosuppression with an increased risk of opportunistic infections particularly with cytomegalovirus reactivation. Hematologic toxicity can occur and blood counts need to be monitored Alemtuzumab is now being studied in combination with CHOP therapy as upfront therapy for PTCL.
In one study of 24 patients, the RR was 71% with a failure free survival of 48% at 2 years and an overall Imatinib molecular weight survival of 53%. It has been studies as a single agent in CTCL where the ORR has been reported as 50%, but there was an increased incidence of cardiac toxicity in this small phase II study of 8 patients. 9.2 Anti CD30 CD30, a member of the TNF receptor is expressed on malignant hematopoetic cells including Hodgkin lymphoma, ALCL, primary cutaneous ALCL, lymphomatoid papulosis and certain cases of transformed MF. There are several monoclonal antibodies that target CD30. SGN30 developed by Seatle Genetics has shown promising activity against ALCL in a phase I trial with no toxicity. The agent is now being studied in a broader phase II trial in ALCL. However, a Cancer and Leukemia Group B trial combining this agent with systemic chemotherapy in pediatirc ALCL showed increased pulmonary toxicity .
A phase II trial of single agent SGN 30 in cutaneous ALCL, lyP and MF has shown a promising clinical benefit of 87% . The median duration of CR and PRs was 84 days. The dose was 4 mg/kg given every 3 weeks, which was then increased to 12 mg/kg. Side effects Rolipram price were minimal. This agent is now being studied in a broader national multicenter trial in patients with ALCL. 9.3 Anti CD4 CD4 belongs to the immunoglobulin superfamily and acts as the coreceptor of T cell receptor . It is normally expressed in helper T cells, regulatory T cells, macrophages, monocytes and dendritic cells, and highly expressed by T cell malignancies including PTCLs and CTCLs.
Different monoclonal antibodies against T cell antigens have been developed and tried preclinically and clinically in T cell lymphomas without major success. Knox et al. reported results with SK3, a chimeric anti CD4 antibody, in seven patients with MF with some effect and a good safety Lapatinib ic50 profile. The trial was limited by the development of antichimeric antibodies. M T412, an anti CD4 chimeric antibody directed against a different epitope of the CD4 molecule, demonstrated a higher affinity and was able to induce CD4 lymphocyte depletion through an Fc mediated mechanism. This was studied in MF and showed an ORR of 88% with psychological examination freedom from progression lasting 25 weeks. 9.4 Zanolimumab This is a fully human anti CD4 monoclonal antibody , under active investigation for the treatment of CD4 malignancies, mainly CTCL in early and advanced stages and other non cutaneous PTCLs. A phase II trial in refractory CTCL was reported by Obitz et al. with a response of 40%.