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Systemic Anti-Cancer Therapy Regimen Library

Home > LEU T-PLL - aLEMTUzumab [IV]

LEU T-PLL - aLEMTUzumab [IV]

Treatment Overview

Give until remission for up to 12 cycles.


The intravenous route of aLEMTUzumab administration remains the treatment of choice for newly diagnosed patients with T-cell prolymphocytic leukaemia (T-PLL).

Cycle 1 - 7 days

Cycle length:
7

aLEMTUzumab:

  • Alternative dose escalation schedule for aLEMTUzumab days 1, 2 and 3 (as above) is to administer the IV dose as 3 mg day 1, 10 mg day 3 and 30 mg day 5.
  • If treatment is interrupted for more than 7 days for any reason, re-initiate aLEMTUzumab at 3 mg, and escalate as above.
  • For T-PLL the intravenous route of administration has been recommended.

Cycles 2 to 12 - 7 days

Cycle length:
7

aLEMTUzumab:

  • If treatment is interrupted for more than 7 days for any reason, re-initiate aLEMTUzumab at 3 mg, and escalate as per Cycle 1.
  • For T-PLL the intravenous route of administration has been recommended.

Cycle details

Cycle 1 - 7 days

Medication Dose Route Days Max Duration
dexamethasone * 8 mg flat dosing intravenous 1, 2, 3,
5		 15 minutes
paracetamol 1000 mg flat dosing oral administration 1, 2, 3,
5
loratadine * 10 mg oral administration 1, 2, 3,
5
aLEMTUzumab 3 mg flat dosing intravenous 1 120 minutes
aLEMTUzumab 10 mg flat dosing intravenous 2 120 minutes
aLEMTUzumab 30 mg flat dosing intravenous 3, 5 120 minutes

aLEMTUzumab:

  • Alternative dose escalation schedule for aLEMTUzumab days 1, 2 and 3 (as above) is to administer the IV dose as 3 mg day 1, 10 mg day 3 and 30 mg day 5.
  • If treatment is interrupted for more than 7 days for any reason, re-initiate aLEMTUzumab at 3 mg, and escalate as above.
  • For T-PLL the intravenous route of administration has been recommended.

Cycles 2 to 12 - 7 days

Medication Dose Route Days Max Duration
paracetamol 1000 mg flat dosing oral administration 1, 3, 5
loratadine * 10 mg oral administration 1, 3, 5
aLEMTUzumab 30 mg flat dosing intravenous 1, 3, 5 120 minutes

aLEMTUzumab:

  • If treatment is interrupted for more than 7 days for any reason, re-initiate aLEMTUzumab at 3 mg, and escalate as per Cycle 1.
  • For T-PLL the intravenous route of administration has been recommended.

Full details

Cycle 1 - 7 days

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 8 mg flat dosing intravenous 15 minutes
Instructions:

ONE hour prior to aLEMTUzumab.
paracetamol 1000 mg flat dosing oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 3 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Day: 2

Medication Dose Route Max duration Details
dexamethasone * 8 mg flat dosing intravenous 15 minutes
Instructions:

ONE hour prior to aLEMTUzumab.
paracetamol 1000 mg flat dosing oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 10 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Alternative schedule is to give this dose on Day 3.

Day: 3

Medication Dose Route Max duration Details
dexamethasone * 8 mg flat dosing intravenous 15 minutes
Instructions:

ONE hour prior to aLEMTUzumab.
paracetamol 1000 mg flat dosing oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 30 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Alternative schedule is to give this dose on Day 5.

Day: 5

Medication Dose Route Max duration Details
dexamethasone * 8 mg flat dosing intravenous 15 minutes
Instructions:

ONE hour prior to aLEMTUzumab.
paracetamol 1000 mg flat dosing oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 30 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Cycles 2 to 12 - 7 days

Day: 1

Medication Dose Route Max duration Details
paracetamol 1000 mg flat dosing oral administration
Instructions:

ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 30 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Day: 3

Medication Dose Route Max duration Details
paracetamol 1000 mg flat dosing oral administration
Instructions:

ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 30 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Day: 5

Medication Dose Route Max duration Details
paracetamol 1000 mg flat dosing oral administration
Instructions:

ONE hour prior to aLEMTUzumab.
loratadine * 10 mg oral administration
Instructions:
ONE hour prior to aLEMTUzumab.
aLEMTUzumab 30 mg flat dosing intravenous 120 minutes
Instructions:

For T-PLL the intravenous route of administration has been recommended.

Supportive Care Factors

Factor Value
Antifungal prophylaxis: Routine antifungal prophylaxis recommended
Antiviral prophylaxis for hepatitis B virus: Required for anti–HBc positive patients at risk of reactivation
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
CMV monitoring: Recommended
Emetogenicity: Minimal
Hypersensitivity / Infusion related reaction risk: High - routine premedication recommended
Irradiated blood components: Irradiation of blood components is recommended
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis is recommended

References

Dearden CE, Khot A, Else M, Hamblin M, Grand E, Roy A, Hewamana S, Matutes E, Catovsky D. Alemtuzumab therapy in T-cell prolymphocytic leukemia: comparing efficacy in a series treated intravenously and a study piloting the subcutaneous route. Blood. 2011 Nov 24;118(22):5799-802. doi: 10.1182/blood-2011-08-372854. Epub 2011 Sep 26., PMID: 21948296

Keating MJ, Cazin B, Coutré S, Birhiray R, Kovacsovics T, Langer W, Leber B, Maughan T, Rai K, Tjønnfjord G, Bekradda M, Itzhaki M, Hérait P. Campath-1H treatment of T-cell prolymphocytic leukemia in patients for whom at least one prior chemotherapy regimen has failed. J Clin Oncol. 2002 Jan 1;20(1):205-13. doi: 10.1200/JCO.2002.20.1.205., PMID: 11773171

Dearden CE, Matutes E, Cazin B, Tjønnfjord GE, Parreira A, Nomdedeu B, Leoni P, Clark FJ, Radia D, Rassam SM, Roques T, Ketterer N, Brito-Babapulle V, Dyer MJ, Catovsky D. High remission rate in T-cell prolymphocytic leukemia with CAMPATH-1H. Blood. 2001 Sep 15;98(6):1721-6. doi: 10.1182/blood.v98.6.1721., PMID: 11535503

Sanofi-Aventis Australia Pty Ltd MABCAMPATH Australian Product Information Sheet 23 December 2021 https://www.ebs.tga.gov.au/ebs/picmi/picmirepository.nsf/pdf?OpenAgent&id=CP-2011-PI-01413-3&d=20220111172310101 (accessed 20 January 2022).

New Zealand Blood Service Transfusion Medicine Handbook Third Edition, 2016 https://www.nzblood.co.nz/assets/Transfusion-Medicine/PDFs/111G122.pdf (accessed 3/2/2022).

Doyle J, Raggatt M, Slavin M, McLachlan SA, Strasser SI, Sasadeusz JJ, Howell J, Hajkowicz K, Nandurkar H, Johnston A, Bak N, Thompson AJ. Hepatitis B management during immunosuppression for haematological and solid organ malignancies: an Australian consensus statement. Med J Aust. 2019 Jun;210(10):462-468, PMID: 31104328

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.