Earlier Campath-1G and -1M research in Europe is insightful into the potential uses and efficacy of Campath-1H in hematologic malignancies; however, Campath-1H has yet to be studied and used (especially in the U.S.) to the extent of the original rat antibodies (especially in transplant), but studies appear VERY promising. Moreover, the efficacy of Campath-1H is CLL and PLL is quite dramatic even in otherwise chemo-refractory patients. One last note, Campath-1H is expected to have equivalent or greater effects in hematological maligancies as the original rat -1G and -1M without the complications of using another species of antibody in humans. Thus, Campath-1H is the humanized version of the original rat antibody and readers should note whether literature citations describing Campath are reporting on the original rat antibodies (-1G and -1M) or the humanized (and soon-to-be FDA approved) Campath-1H.
Campath is now FDA-approved for the treatment of patients with B-CLL who have been treated with alkylating agents such as chlorambucil and whose disease no longer responds to fludarabine.
CRITERIA:
Cam511 will be available for those CLL patients who have failed
fludarabine (Fludara) (alone or in combination) within six months of
treatment or those prolymphocytic leukemia patients (PLL) who have
failed any treatment. Based on the phase II trial of Campath-1H, the
results show that 33 percent of patients who had failed other
treatment options responded to Campath and 59 percent had stablized
disease.
Campath is given through a needle into a vein (intravenously). Many patients will be given a central venous catheter (also called a port) so that treatment may be done through the catheter and the misery of repeated needle sticks is avoided. Having the catheter inserted is a minor surgery and many patients have trouble dealing with the lumens sticking up. However, the freedom from constant needle sticks is an excellent trade off for many patients.
Campath is used in an effort to kill circulating leukemia cells found in the bone marrow and organs.
Campath gets into the bone marrow, and also attempts to rid the body of leukemia cells in other reservoirs such as the spleen, liver and the lymph nodes. Like an onion, the treatment starts on the outside of a node, eliminates the outer layers, and attempts to work its way into the center of the node. Therefore, it may take a while to get through the other layers, and if it's a very large node, it may never get to the center.
Because Campath-1H eliminates all B and T cells (good and bad), one must be VERY careful to avoid infection. While taking Campath, consider yourself a pre-bone marrow transplant (BMT) patient who is very immunocompromised. Some white cells (called neutrophils) remain relatively untouched by Campath, however most lymphocytes (B and T cells) are eliminated.
It is not uncommon for patients to have some reaction to this drug during the first week of dose escalation. Your nurse will be watching for signs of a reaction, but be sure to let her know if you're feeling anything unusual during administration. For most reactions to treatment, your nurse or doctor can safely treat your symptoms with medications to allow continued treatment with Campath.
DO NOT DRIVE yourself to treatment -- please get someone else to do the driving.
Do not inhale DIRT or DUST from dirt while being treated with Campath. It is sensible to tell friends