B-Cell Chronic Lymphocytic Leukemia
- Initial dose: 3 mg/day IV until tolerated (usually 3-7 days)
- Titrate: 10 mg/day IV until tolerated; then 30 mg IV three times per week
- Max: 30 mg/dose; 90 mg/wk
- Total duration of therapy: 12 weeks
Dose modification for Neutropenia or Thrombocytopenia
With a baseline absolute neutrophil count [ANC] < 250/mcL and/or a platelet count 
25,000/mcL
- For first occurrence: withhold alemtuzumab therapy; resume at 30 mg/day IV when ANC is at least 500/mcL and platelet count is at least 50,000/mcL
- Second occurrence: withhold alemtuzumab; resume at 10 mg/day IV when ANC is at least 500/mcL and platelet count is at least 50,000/mcL
- Third occurrence: discontinue alemtuzumab therapy
50% decrease from baseline in patients initiating therapy with a baseline ANC 250/mcL and/or a baseline platelet count 25,000/mcL:
- First occurrence: Withhold alemtuzumab therapy; resume at 30 mg/day IV upon return to baseline values
- Second occurrence: Withhold alemtuzumab; resume at 10 mg/day IV upon return to baseline values
- Third occurrence: Discontinue alemtuzumab therapy
- Dose modification for Neutropenia or Thrombocytopenia: If the delay between dosing <7 days, resume therapy at same dose. If delay 7 days or more, resume therapy at 3 mg/day IV , increasing to 10 mg/day IV and then 30 mg/day IV as tolerated
- Premedicate with diphenhydramine 50 mg and acetaminophen 500 to 1,000 mg 30 minutes prior to first infusion and each dose escalation
- Safety and effectiveness in pediatric population have not been established
