Variable CD52 expression in mature T cell and NK cell malignancies: implications for alemtuzumab therapy

Br J Haematol. 2009 Apr;145(2):173-9. doi: 10.1111/j.1365-2141.2009.07606.x. Epub 2009 Feb 19.

Abstract

The anti-CD52 antibody alemtuzumab has been explored as a novel targeted therapy in T cell malignancies. To assess the suitability of alemtuzumab therapy, we carried out a comprehensive study of CD52 expression using flow cytometry (FC) in 78 untreated patients diagnosed with mature T/natural killer (NK) cell neoplasms, including 34 adult T cell leukaemia/lymphomas (ATLL), two anaplastic large cell lymphomas (ALCL), three angioimmunoblastic T cell lymphomas (AITL), 16 cutaneous T cell lymphomas (CTCL), four extra-nodal T/NK cell lymphomas (ENT/NKCL), four hepatosplenic T cell lymphomas (HSTCL), 13 peripheral T cell lymphomas, not otherwise specified (PTCL-NOS) and two T-prolymphocytic leukaemia (T-PLL). The level of CD52 expression was quantified using QuantiBRITE standard beads. The level of CD52 expression varied widely within each diagnostic category. All AITL, HSTCL and T-PLL cases were CD52-positive and the frequency of CD52 expression was high in PTCL-NOS (92.3%), ATLL (94.1%) and CTCL (87.5%), implying a rational role for alemtuzumab in the treatment of these diseases; however, CD52 expression was low in ALCL (50%) and ENT/NKCL (25%). FC testing for cell surface expression of CD52 is indicated in patients with T/NK cell malignancies being considered for alemtuzumab therapy. Further studies are necessary to determine if the level of CD52 expression correlates with response to therapy.

MeSH terms

  • Alemtuzumab
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / therapeutic use*
  • Antigens, CD / analysis*
  • Antigens, Neoplasm / analysis*
  • Antineoplastic Agents / therapeutic use*
  • CD52 Antigen
  • Case-Control Studies
  • Flow Cytometry / methods
  • Glycoproteins / analysis*
  • Humans
  • Immunophenotyping / methods
  • Ki-1 Antigen / analysis
  • Killer Cells, Natural / immunology
  • Lymphoma, Extranodal NK-T-Cell / immunology
  • Lymphoma, T-Cell / immunology*
  • Prospective Studies
  • T-Lymphocytes / immunology
  • Treatment Failure

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • Antigens, CD
  • Antigens, Neoplasm
  • Antineoplastic Agents
  • CD52 Antigen
  • CD52 protein, human
  • Glycoproteins
  • Ki-1 Antigen
  • Alemtuzumab