Treatment Options for T-Cell Prolymphocytic Leukemia

Cladribine appears to be an active agent (60% complete remission rate) for patients with de novo B-cell PLL.[4][Level of evidence C3] Anecdotal responses have been seen with venetoclax.[5][Level of evidence C3] Alemtuzumab, an anti-CD52 humanized monoclonal antibody, has been used for 76 patients with T-cell PLL after failure of previous chemotherapy (usually pentostatin or cladribine). The response rate was 51% (95% confidence interval, 40%–63%), and the median time to progression was 4.5 months (range, 0.1–45.4).[6][Level of evidence C3] These response rates have been confirmed by other investigators.[7] Patients with chronic lymphocytic leukemia (CLL) and prolymphocytoid transformation maintain the classic CLL phenotype and have a worse prognosis than patients with PLL.