Biological therapy for chronic lymphocytic leukaemia (CLL) | Cancer Research UK
Cancer Research UK on Google+ Cancer Research UK on Facebook Cancer Research UK on Twitter

Biological therapy for chronic lymphocytic leukaemia (CLL)

Men and women discussing chronic lymphocytic leukaemia

This page is about biological therapy for chronic lymphocytic leukaemia (CLL). There is information about

 

A quick guide to what's on this page

Biological therapy for chronic lymphocytic leukaemia (CLL)

Biological therapy is treatment with substances that are made naturally in the body or change the way that particular substances work in the body. Doctors use a type of biological therapy called monoclonal antibodies (MAB's) for CLL. 

The main biological therapies used for CLL are rituximab and alemtuzumab.

Rituximab (Rituxan)

Rituximab works by seeking out a protein that is found on normal and leukaemic white blood cells (lymphocytes). Once it has found the lymphocytes, it sticks to them. The immune system then targets the cells and kills them. Normal lymphocytes then grow to replace those that are destroyed. Rituximab, in combination with fludarabine and cyclophosphamide chemotherapy, is now the first treatment used for most physically fit people with CLL. The most common side effect of rituximab is a reaction to the drug when you first have it.

Alemtuzumab (Mabcampath)

Alemtuzumab works by finding and attaching itself to the cancerous white blood cells (lymphocytes) and then killing them. You are most likely to have alemtuzumab if your CLL has stopped responding to chemotherapy. But alemtuzumab may sometimes be useful as a first treatment for physically fit people with CLL. Alemtuzumab can lower your resistance to infection. To help protect you against infection while you are having this drug, your doctor will give you antibiotics to take.

 

CR PDF Icon You can view and print the quick guides for all the pages in the Treating CLL section.

 

 

What biological therapy is

Biological therapy is treatment with substances that are made naturally in the body or that change the way particular substances work in the body. We can now make some of these artificially.

 

Monoclonal antibody treatment for CLL

Types of biological therapy called monoclonal antibodies (MABS) can be used to treat CLL. An antibody is a protein that is attracted to a particular type of cell. Monoclonal antibodies are multiple copies of an individual antibody. Those used for CLL may disrupt the leukaemia cell processes so that the cell stops dividing or dies. Or the MABs may stick to the leukaemia cells and trigger the immune system to destroy them. 

There are several monoclonal antibodies used to treat CLL such as

Rituximab (Rituxan)  

Rituximab works by seeking out a protein called CD20 found on normal and leukaemic white blood cells (lymphocytes). Once it has found the lymphocytes, it sticks to them and the immune system then targets the cells and kills them. Normal lymphocytes then grow to replace those that are destroyed.

Rituximab, in combination with the chemotherapy drugs, fludarabine and cyclophosphamide is the most commonly used first line treatment for people with CLL who are physically fit. We have more detailed information about Rituximab

Alemtuzumab (Campath 1H)  

Alemtuzumab is also called Mabcampath, Campath, or Campath 1H. You are most likely to have alemtuzumab if your CLL has stopped responding to chemotherapy or has come back after chemotherapy treatment. But alemtuzumab may sometimes be useful as a first treatment for physically fit people with CLL. You may have alemtuzumab with a steroid (methylprednisolone) if your CLL is found to have a change (mutation) in the p53 gene.

Alemtuzumab works best in patients with CLL who don't have a lot of very enlarged lymph nodes. It works by finding and attaching itself to the cancerous white blood cells (lymphocytes) and then killing them. We have more detailed information about Alemtuzumab.

Ofatumumab (Arzerra)

Ofatumumab targets part of a protein called CD20 on the surface of the CLL cells. The ofatumumab sticks to all the CD20 proteins it finds. Then all the cells of the immune system pick out the marked cells and kill them. We have more detailed information about Ofatumumab.

The Scottish Medicines Consortium (SMC) have said that ofatumumab in combination with chlorambucil should be available as a treatment for people within the NHS in Scotland. They say it should be available for people as a first treatment if treatments containing bendaumstine or fludarabine are not suitable. The National Institute for Health and Care Excellence (NICE) say people with CLL can have ofatumumab with chlorambucil in England and Wales. This is also for people who have not had previous treatment, and who are not suitable for treatments containing fludarabine or bendumastine. 

 

Where to find more information

There is information about the different types of biological therapies, including monoclonal antibodies in the cancer treatment section. Our CLL research page has information on drugs that are currently being researched for CLL. 

cell cycle - nobel prize

Rate this page:
Submit rating

 

Rated 5 out of 5 based on 7 votes
Rate this page
Rate this page for no comments box
Please enter feedback to continue submitting
Send feedback
Question about cancer? Contact our information nurse team

No Error

Updated: 10 March 2015