Johnson, P.W. (2009) Randomized comparison of the stanford V regimen and ABVD in the treatment of advanced Hodgkin’s Lymphoma: United Kingdom National Cancer Research Institute Lymphoma Group Study ISRCTN 64141244. Journal of Clinical Oncology, 27, 5390–5396. Johnson, P., Federico, M., Kirkwood, A., Fossa, A., Berkahn, L., Carella, A., d’Amore, F., Enblad, G., Franceschetto, A., Fulham, M., Luminari, S., O’Doherty, M., Patrick, P., Roberts, T., Sidra, G., Stevens, L., Smith, P., Trotman, J., Viney, Z., Radford, J. & Barrington, S. (2016) Adapted treatment guided by interim PET-CT scan in advanced Hodgkin’s lymphoma. New England Journal of Medicine, 374, 2419–2429. Press, O.W., Li, H., Schoder, H., Straus, D.J., Moskowitz, C.H., LeBlanc, M., Rimsza, L.M., Bartlett, N.L., Evens, A.M., Mittra, E.S., LaCasce, A.S., Sweetenham, J.W., Barr, P.M., Fanale, M.A., Knopp, M.V., Noy, A., Hsi, E.D., Cook, J.R., Lechowicz, M.J., Gascoyne, R.D., Leonard, J.P., Kahl, B.S., Cheson, B.D., Fisher, R.I. & Friedberg, J.W. (2016) US intergroup trial of response-adapted therapy for stage III to IV Hodgkin lymphoma using early interim fluorodeoxyglucose-positron emission tomogra- phy imaging: Southwest Oncology Group S0816. Journal of Clinical Oncology, 34, 2020– 2027. Rigacci, L., Puccini, B., Zinzani, P.L., Biggi, A., Castagnoli, A., Merli, F., Balzarotti, M., Steli- tano, C., Spina, M., Vitolo, U., Stefoni, V., Levis, A., Gotti, M., Rosaria, S., Maria, S.P., Bosi, A. & Gallamini, A. (2015) The prognostic value of positron emission tomography per- formed after two courses (INTERIM-PET) of standard therapy on treatment outcome in early stage Hodgkin lymphoma: a multicentric study by the fondazione italiana linfomi (FIL). Ameri- can Journal of Hematology, 90, 499–503. Therapeutic outcomes using subcutaneous low dose alemtuzumab for acquired bone marrow failure conditions Aplastic anaemia (AA), pure red cell aplasia (PRCA), pure white cell aplasia (PWCA) and immune cytopenias (IC) associated with T-cell large-granular lymphocytic leukaemia (T-LGL) share certain aspects of immune-pathogenesis. Poly- clonal, clonally skewed or clonal cytotoxic T-lymphocytes (CTLs) mediate cytopenias (Young & Maciejewski, 1997; Risi- tano et al, 2010; Dumitriu et al, 2016). Immunosuppressive therapy (IST) has been used to ameliorate cytopenias and, in some cases, restore normal haematopoiesis. Refractoriness to front-line therapies results from insufficient IST, or exhaustion of the haematopoietic stem/progenitor cells, necessitating ther- apeutic alternatives (Risitano & Schrezenmeier, 2013). Alem- tuzumab, a humanized IgG1 anti-CD52 monoclonal antibody, profoundly depletes B- and T-cells. Applied initially as a high- dose intravenous regimen for chronic lymphocytic leukaemia (CLL), alemtuzumab has subsequently been adopted as a form of IST (Willis et al, 2001). Alemtuzumab is currently marketed for autoimmune diseases like multiple sclerosis, although its potential therapeutic utility in refractory IC has been noted (Willis et al, 2001). Early applications as an IST for acquired bone marrow failure (aBMF) adopted dosing analogous to CLL. With overall response-rates (ORR) of 37–80%, adminis- tration of intravenous alemtuzumab dose-intense regimens had significant infusional and IST-related adverse events (AEs) (Willis et al, 2001). Due to lack of therapeutic superiority to anti-thymocyte globulin (ATG) in frontline settings, alem- tuzumab has not been widely adopted for upfront IST in AA (Scheinberg et al, 2012). Subcutaneous (sc) administration at lower doses has better tolerability and acceptable AEs (Gomez- Almaguer et al, 2010; Risitano et al, 2010). Consequently, alemtuzumab became a viable therapeutic option in patients Table I. Treatment outcomes and adverse events from sc alemtuzumab therapy in patients with acquired bone marrow failure. N = 59 Treatment outcomes (%) ORR 63 CR 36 PR 27 Age <60 years 645 >60 years 61 Diagnosis AA 60 PRCA 62 T-LGL 60 IN/PWCA 100 Disease status Treatment na€ıve 71 Relapsed 65 Refractory 52 Therapy discontinuation* Injection reaction 1 Patient preference 3 Adverse events Injection reactions 20 Infections 29 Clonal events 6 AA, aplastic anaemia; CR, complete response; IC, immune cytopenia; ORR, overall response rate; PR, partial response; PRCA, pure red cell aplasia; PWCA, pure white cell aplasia; T-LGL, T-cell large-granular lymphocytic leukaemia. *4 discontinued treatment. ª 2017 British Society for Haematology and John Wiley & Sons Ltd 133 British Journal of Haematology, 2018, 183, 127–155 Correspondence