Treatment of Chronic Lymphocytic Leukemia With Alemtuzumab: A Review for Nurses

Purpose/Objectives: To review the use of the monoclonal antibody alemtuzumab in patients with advanced refractory B cell chronic lymphocytic leukemia (B-CLL) and nursing management during treatment.

Data Sources: Published articles, abstracts, book chapters, Web sites, and training material.

Data Synthesis: Alemtuzumab can achieve disease remission in patients with chemorefractory B-CLL; however, management of high-risk patients presents certain challenges. Infusion-related events can be minimized by stepwise administration and appropriate prophylaxis. Cytopenia can be minimized by drug postponement and cytokine support or red blood cell or platelet transfusions. Patients also are at risk for infection because of lymphopenia, and anti-infective prophylaxis is mandatory at initiation of therapy until at least two months post-treatment.

Conclusions: With satisfactory supportive measures in place, patients with chemorefractory B-CLL can experience the benefits of alemtuzumab therapy without excessive toxicity.

Implications for Nursing: Nurses should be familiar with treatment and prophylactic protocols, be ready to offer supportive therapy to control side effects, and invest time in patient education.