Monoclonal antibody therapy of chronic lymphocytic leukaemia

The availability of safe and effective monoclonal antibodies has revolutionised the treatment strategies for patients with chronic lymphocytic leukaemia (CLL). Alemtuzumab, the first antibody approved for these patients, induces responses in one-third of relapsed and refractory patients, and in more than 80% when used as initial therapy. Rituximab, while exhibiting modest single-agent activity, improves the response rate when added to standard chemotherapy and may even prolong patient survival. The most recent antibody to be approved by regulatory agencies is ofatumumab, a new anti-CD20 antibody, with efficacy in patients whose disease is refractory to both fludarabine and alemtuzumab. Other antibodies or related molecules in development are directed at antigens, such as CD20, CD23 and CD37. Through rational combinations with chemotherapy and other biologic agents, the outcome for patients with CLL will further improve.