A Phase II Study of Ofatumumab in Combination With High-dose Methylprednisolone in Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia (CLL)

Inclusion Criteria:

1. Previously treated patients with a diagnosis of CLL

2. Previous treatment with any monoclonal antibody or chemotherapy regardless of
response as defined by the iwCLL Working Group Guidelines as evidenced by:

- progressive marrow failure as manifested by the development of, or worsening of,
anemia and/or thrombocytopenia

- massive (i.e. at least 6cm below the left costal margin) or progressive or
symptomatic splenomegaly

- massive nodes (i.e. at least 10cm in longest diameter) or progressive or
symptomatic lymphadenopathy.

- progressive lymphocytosis with an increase of more than 50% over a 2-month
period or lymphocyte doubling time (LDT) of less than 6 months.

- autoimmune anemia and/or thrombocytopenia that is poorly responsive to
corticosteroids or other standard therapy (See Section 10.2)

3. Constitutional symptoms, defined as any one or more of the following disease-related
symptoms or signs: unintentional weight loss of 10% or more within the previous 6
months significant fatigue (i.e. ECOG PS 2 or worse, inability to work or perform
usual activities), fevers higher than 100.5ºF or 38.0ºC for 2 or more weeks without
other evidence of infection, night sweats for more than 1 month without evidence of
infection

4. Subjects must be 18 years of age or older, male or female.

5. ECOG performance status of 0-2.

6. Subjects must be able to give informed consent.

7. Females of child bearing potential(FCBP)† must have a negative serum or urine
pregnancy test within 10 - 14 days prior to and again within 24 hours of starting
treatment and agree to use a medically accepted contraceptive method for the duration
of this study.

Exclusion Criteria:

1. Hepatitis BsAg positive, Hepatitis BcAb positive, and Hepatitis C positive patients.

2. Known HIV positive patients.

3. Diabetics.

4. Patients with uncontrolled Autoimmune Hemolytic Anemia (AIHA) or autoimmune
thrombocytopenia (ITP).

5. Screening laboratory values within these ranges: platelets <50 x 109/L, neutrophils
<1.0 x 109/L, creatinine >2.0 times upper normal limit,total bilirubin >1.5 times
upper normal limit (unless a known history of Gilbert's disease), ALT >2.5 times
upper normal limit (unless due to disease involvement of liver), alkaline phosphatase
>2.5 times upper normal limit (unless due to disease involvement of the liver or bone
marrow)

6. Inability to provide informed consent.

7. Concurrent malignancy (excluding basal and squamous cell skin cancers).

8. Active fungal, bacterial, and/or viral infection.

9. History of peptic ulcer disease resulting in GI bleeding within the last 6 months.

10. Untreated metabolic disorders such as hypothyroidism and Cushing's disease.

11. History of steroid-induced psychosis.

12. Estimated life expectancy of less than 3 months by the investigator's best clinical
judgment.

13. Serious medical condition that would render the subject medically unstable.

14. Women who are pregnant or breast-feeding.

15. History of Pancreatitis.

16. History of Diverticulitis.

17. Patients with known hypersensitivity to ofatumumab or known history of anaphylaxis to
Rituximab or alemtuzumab.

18. Concurrent use of other anti-cancer agents or treatments.

19. Subjects who have current active hepatic or biliary disease (with exception of
patients with Gilbert's syndrome, asymptomatic gallstones, liver metastases or stable
chronic liver disease per investigator assessment).