Phase 2 study of alemtuzumab and dose-adjusted EPOCH-R in relapsed or refractory aggressive B-cell lymphomas

Rahul Lakhotia; Christopher Melani; Kieron Dunleavy; Stefania Pittaluga; Sanjal Desai; Mark A. Ahlman; Nicole Lucas; Seth M. Steinberg; Elaine S. Jaffe; Wyndham H. Wilson; Mark Roschewski

doi:10.1080/10428194.2025.2457553

Phase 2 study of alemtuzumab and dose-adjusted EPOCH-R in relapsed or refractory aggressive B-cell lymphomas

Rahul Lakhotia
, Christopher Melani
, Kieron Dunleavy
, Stefania Pittaluga
, Sanjal Desai
, Mark A. Ahlman
, Nicole Lucas
, Seth M. Steinberg
, Elaine S. Jaffe
, Wyndham H. Wilson
, Mark Roschewski

Medicine - Hematology, Oncology, Transplant

Research output: Contribution to journal › Article › peer-review

Abstract

Immune cells within the lymphoma tumor microenvironment promote immune evasion and are rational therapeutic targets. Alemtuzumab targets CD52 expressed on malignant B-cells and infiltrating nonmalignant T-cells. We evaluated the safety and efficacy of alemtuzumab with DA-EPOCH-R in 48 patients with relapsed/refractory aggressive B-cell lymphoma. Febrile neutropenia occurred in 18% of cycles and serious infections in 21% of patients. Responses were observed in 30 (62%) patients, including 12 (80%) patients with classical HL and 3 (75%) patients with T-cell/histiocyte-rich large B-cell lymphoma (THRLCL). Seventeen (35%) patients achieved complete responses, and 12 (25%) were bridged to consolidation. The 2-year progression-free survival (PFS) and overall survival were 22.1% (95% CI, 11.5–34.7%) and 45.2% (95% CI, 34.3–58.9%), respectively. The 2-year PFS for HL and THRLCL patients was 35% and 50%, respectively. Alemtuzumab can be safely combined with DA-EPOCH-R in relapsed/refractory aggressive B-cell lymphomas and can induce durable responses in patients with T-cell-rich microenvironments.

Original language	English (US)
Pages (from-to)	1088-1099
Number of pages	12
Journal	Leukemia and Lymphoma
Volume	66
Issue number	6
DOIs	https://doi.org/10.1080/10428194.2025.2457553
State	Published - 2025

Bibliographical note

Publisher Copyright:
© This work was authored as part of the Contributor’s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Alemtuzumab
Hodgkin lymphoma
T-cell/histiocyte-rich large B-cell lymphoma
large B-cell lymphoma

PubMed: MeSH publication types

Journal Article
Clinical Trial, Phase II

Publisher link

10.1080/10428194.2025.2457553

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@article{8910250c9e304d70bd74d38cb638c7df,

title = "Phase 2 study of alemtuzumab and dose-adjusted EPOCH-R in relapsed or refractory aggressive B-cell lymphomas",

abstract = "Immune cells within the lymphoma tumor microenvironment promote immune evasion and are rational therapeutic targets. Alemtuzumab targets CD52 expressed on malignant B-cells and infiltrating nonmalignant T-cells. We evaluated the safety and efficacy of alemtuzumab with DA-EPOCH-R in 48 patients with relapsed/refractory aggressive B-cell lymphoma. Febrile neutropenia occurred in 18\% of cycles and serious infections in 21\% of patients. Responses were observed in 30 (62\%) patients, including 12 (80\%) patients with classical HL and 3 (75\%) patients with T-cell/histiocyte-rich large B-cell lymphoma (THRLCL). Seventeen (35\%) patients achieved complete responses, and 12 (25\%) were bridged to consolidation. The 2-year progression-free survival (PFS) and overall survival were 22.1\% (95\% CI, 11.5{\textendash}34.7\%) and 45.2\% (95\% CI, 34.3{\textendash}58.9\%), respectively. The 2-year PFS for HL and THRLCL patients was 35\% and 50\%, respectively. Alemtuzumab can be safely combined with DA-EPOCH-R in relapsed/refractory aggressive B-cell lymphomas and can induce durable responses in patients with T-cell-rich microenvironments.",

keywords = "Alemtuzumab, Hodgkin lymphoma, T-cell/histiocyte-rich large B-cell lymphoma, large B-cell lymphoma",

author = "Rahul Lakhotia and Christopher Melani and Kieron Dunleavy and Stefania Pittaluga and Sanjal Desai and Ahlman, \{Mark A.\} and Nicole Lucas and Steinberg, \{Seth M.\} and Jaffe, \{Elaine S.\} and Wilson, \{Wyndham H.\} and Mark Roschewski",

note = "Publisher Copyright: {\textcopyright} This work was authored as part of the Contributor{\textquoteright}s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.",

year = "2025",

doi = "10.1080/10428194.2025.2457553",

language = "English (US)",

volume = "66",

pages = "1088--1099",

journal = "Leukemia and Lymphoma",

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publisher = "Taylor and Francis Ltd.",

number = "6",

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TY - JOUR

T1 - Phase 2 study of alemtuzumab and dose-adjusted EPOCH-R in relapsed or refractory aggressive B-cell lymphomas

AU - Lakhotia, Rahul

AU - Melani, Christopher

AU - Dunleavy, Kieron

AU - Pittaluga, Stefania

AU - Desai, Sanjal

AU - Ahlman, Mark A.

AU - Lucas, Nicole

AU - Steinberg, Seth M.

AU - Jaffe, Elaine S.

AU - Wilson, Wyndham H.

AU - Roschewski, Mark

N1 - Publisher Copyright: © This work was authored as part of the Contributor’s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 U.S.C. 105, no copyright protection is available for such works under U.S. Law.

PY - 2025

Y1 - 2025

N2 - Immune cells within the lymphoma tumor microenvironment promote immune evasion and are rational therapeutic targets. Alemtuzumab targets CD52 expressed on malignant B-cells and infiltrating nonmalignant T-cells. We evaluated the safety and efficacy of alemtuzumab with DA-EPOCH-R in 48 patients with relapsed/refractory aggressive B-cell lymphoma. Febrile neutropenia occurred in 18% of cycles and serious infections in 21% of patients. Responses were observed in 30 (62%) patients, including 12 (80%) patients with classical HL and 3 (75%) patients with T-cell/histiocyte-rich large B-cell lymphoma (THRLCL). Seventeen (35%) patients achieved complete responses, and 12 (25%) were bridged to consolidation. The 2-year progression-free survival (PFS) and overall survival were 22.1% (95% CI, 11.5–34.7%) and 45.2% (95% CI, 34.3–58.9%), respectively. The 2-year PFS for HL and THRLCL patients was 35% and 50%, respectively. Alemtuzumab can be safely combined with DA-EPOCH-R in relapsed/refractory aggressive B-cell lymphomas and can induce durable responses in patients with T-cell-rich microenvironments.

AB - Immune cells within the lymphoma tumor microenvironment promote immune evasion and are rational therapeutic targets. Alemtuzumab targets CD52 expressed on malignant B-cells and infiltrating nonmalignant T-cells. We evaluated the safety and efficacy of alemtuzumab with DA-EPOCH-R in 48 patients with relapsed/refractory aggressive B-cell lymphoma. Febrile neutropenia occurred in 18% of cycles and serious infections in 21% of patients. Responses were observed in 30 (62%) patients, including 12 (80%) patients with classical HL and 3 (75%) patients with T-cell/histiocyte-rich large B-cell lymphoma (THRLCL). Seventeen (35%) patients achieved complete responses, and 12 (25%) were bridged to consolidation. The 2-year progression-free survival (PFS) and overall survival were 22.1% (95% CI, 11.5–34.7%) and 45.2% (95% CI, 34.3–58.9%), respectively. The 2-year PFS for HL and THRLCL patients was 35% and 50%, respectively. Alemtuzumab can be safely combined with DA-EPOCH-R in relapsed/refractory aggressive B-cell lymphomas and can induce durable responses in patients with T-cell-rich microenvironments.

KW - Alemtuzumab

KW - Hodgkin lymphoma

KW - T-cell/histiocyte-rich large B-cell lymphoma

KW - large B-cell lymphoma

UR - https://www.scopus.com/pages/publications/85216774429

UR - https://www.scopus.com/pages/publications/85216774429#tab=citedBy

U2 - 10.1080/10428194.2025.2457553

DO - 10.1080/10428194.2025.2457553

M3 - Article

C2 - 39899393

AN - SCOPUS:85216774429

SN - 1042-8194

VL - 66

SP - 1088

EP - 1099

JO - Leukemia and Lymphoma

JF - Leukemia and Lymphoma

IS - 6

ER -

Phase 2 study of alemtuzumab and dose-adjusted EPOCH-R in relapsed or refractory aggressive B-cell lymphomas

Abstract

Bibliographical note

UN SDGs

Keywords

PubMed: MeSH publication types

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