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Alemtuzumab
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Christopher J.e. Watson – One of the best experts on this subject based on the ideXlab platform.
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Subcutaneous administration of Alemtuzumab in simultaneous pancreas-kidney transplantation.
Transplantation, 2007Co-Authors: Menna R. Clatworthy, Rajesh Sivaprakasam, Andrew J. Butler, Christopher J.e. WatsonAbstract:Alemtuzumab (MabCampath, Campath-1H) is a potent lymphocyte-depleting monoclonal antiantibody increasingly used at induction in solid orgaorgan trantransplantation. Previously, it had been given by intravenous infusion; such administration is associated with a first-dose cytokine release syndrome characterized by fever and hypotension. Subcutaneous administration of Alemtuzumab avoids this first-dose reaction while achieving a similar concentration to intravenous administration. The avoidance of infusion-associated hypotension is particularly important in pancreas trantransplantation where venous thrombosis is a major problem. We therefore treated 21 recipients of combined pancreas and kidney transplants with two 30-mg doses of Alemtuzumab administered subcutaneously on days 0 and 1. No patient suffered a first-dose reaction. Lymphocyte depletion after subcutaneous Alemtuzumab was profound and comparable to that seen in a group of renal transplant recipients who had received intravenous Alemtuzumab. Subcutaneous Alemtuzumab was associated with similar rates of acute rejection (14% at 1 year), patient survival (100%), and pancreas and kidney graft survival (95% and 100%, respectively) to those observed in centers using intravenous Alemtuzumab in simultaneous pancreas kidney trantransplantation. There was no excess incidence of adverse events. We therefore recommend this route of administration to all transplant centers using Alemtuzumab.
Menna R. Clatworthy – One of the best experts on this subject based on the ideXlab platform.
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Subcutaneous administration of Alemtuzumab in simultaneous pancreas-kidney transplantation.
Transplantation, 2007Co-Authors: Menna R. Clatworthy, Rajesh Sivaprakasam, Andrew J. Butler, Christopher J.e. WatsonAbstract:Alemtuzumab (MabCampath, Campath-1H) is a potent lymphocyte-depleting monoclonal antibody increasingly used at induction in solid organ transplantation. Previously, it had been given by intravenous infusion; such administration is associated with a first-dose cytokine release syndrome characterized by fever and hypotension. Subcutaneous administration of Alemtuzumab avoids this first-dose reaction while achieving a similar concentration to intravenous administration. The avoidance of infusion-associated hypotension is particularly important in pancreas transplantation where venous thrombosis is a major problem. We therefore treated 21 recipients of combined pancreas and kidney transplants with two 30-mg doses of Alemtuzumab administered subcutaneously on days 0 and 1. No patient suffered a first-dose reaction. Lymphocyte depletion after subcutaneous Alemtuzumab was profound and comparable to that seen in a group of renal transplant recipients who had received intravenous Alemtuzumab. Subcutaneous Alemtuzumab was associated with similar rates of acute rejection (14% at 1 year), patient survival (100%), and pancreas and kidney graft survival (95% and 100%, respectively) to those observed in centers using intravenous Alemtuzumab in simultaneous pancreas kidney transplantation. There was no excess incidence of adverse events. We therefore recommend this route of administration to all transplant centers using Alemtuzumab.
Hans W Sollinger – One of the best experts on this subject based on the ideXlab platform.
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a comparison of Alemtuzumab with basiliximab induction in simultaneous pancreas kidney transplantation
American Journal of Transplantation, 2008Co-Authors: Joseph F Magliocca, Jon S Odorico, J D Pirsch, Yolanda T Becker, Stuart J Knechtle, G Leverson, Hans W SollingerAbstract:Alemtuzumab is a humanized, rat monoclonal antiantibody directed against the CD52 antiantigen. After binding, Alemtuzumab causes profound and durable depletion and has been successfully used as immune induction therapy for organ trantransplantation. This was a single center, retrospective review of patients who underwent simultaneous pancreas-kidney trantransplantation at the University of Wisconsin using Alemtuzumab induction therapy compared with historical controls that received induction with basiliximab. There were no differences in donor or recipient demographics, rates of patient survival, renal or pancreas allograft survival, renal allograft delayed graft function, EBV infection, BKV infection, PTLD or sepsis. There was a statistically significant increase in the incidence of cytomegalovirus (CMV) infection in the Alemtuzumab-treated group. Given the significantly higher incidence of CMV infections, we have since altered our induction protocol to consist of a single 30 mg dose of Alemtuzumab instead of two doses. The long-term effects of this change remain to be seen. Due to the results seen in this study, the low initial cost of the drug and the absence of any severe, short-term side effects, Alemtuzumab has been selected as the induction drug of choice at our center for patients undergoing SPK.
Michele Parker – One of the best experts on this subject based on the ideXlab platform.
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Alemtuzumab induction and prednisone free maintenance immunotherapy in simultaneous pancreas kidney transplantation comparison with rabbit antithymocyte globulin induction long term results
American Journal of Transplantation, 2006Co-Authors: Dixon B Kaufman, Joseph R Leventhal, Lorenzo Gallon, Michele ParkerAbstract:This study compared the effects of using two T-cell depleting antibodies, Alemtuzumab (anti-CD 52, Campath-1H®) and rabbit antithymocyte globulin (Thymoglobulin®), as induction immunosuppression for recipients of simultaneous pancreas-kidney trantransplantation given a prednisone-free maintenance regimen. We used a single-center, nonrandomised, retrospective, sequential study design to evaluate the efficacy and safety of Alemtuzumab (n = 50) or antithymocyte globulin (n = 38) induction in combination with a prednisone-free, tacrolimus/sirolimus-based immunosuppression protocol. Kaplan-Meier analyses of long-term patient and graft survivals and rejection rates were determined according to induction agent. Secondary endpoints included the quality of renal allograft function, incidence of infectious and malignant complications, and cost considerations. Overall long-term patient and graft survival rates did not significantly differ between patients treated with Alemtuzumab and antithymocyte globulin. Rejection rates were also nearly equivalent at 1 and 2 years. Viral infectious complications were statistically significantly lower in the Alemtuzumab group. The cost of Alemtuzumab induction was lower than antithymocyte globulin. Alemtuzumab induction followed by steroid-free maintenance therapy with a tacrolimus/sirolimus-based immunosuppression regimen provided an effective, safe and cost-conscious approach to SPK transplantation.
Andrew J. Butler – One of the best experts on this subject based on the ideXlab platform.
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Subcutaneous administration of Alemtuzumab in simultaneous pancreas-kidney transplantation.
Transplantation, 2007Co-Authors: Menna R. Clatworthy, Rajesh Sivaprakasam, Andrew J. Butler, Christopher J.e. WatsonAbstract:Alemtuzumab (MabCampath, Campath-1H) is a potent lymphocyte-depleting monoclonal antibody increasingly used at induction in solid organ transplantation. Previously, it had been given by intravenous infusion; such administration is associated with a first-dose cytokine release syndrome characterized by fever and hypotension. Subcutaneous administration of Alemtuzumab avoids this first-dose reaction while achieving a similar concentration to intravenous administration. The avoidance of infusion-associated hypotension is particularly important in pancreas transplantation where venous thrombosis is a major problem. We therefore treated 21 recipients of combined pancreas and kidney transplants with two 30-mg doses of Alemtuzumab administered subcutaneously on days 0 and 1. No patient suffered a first-dose reaction. Lymphocyte depletion after subcutaneous Alemtuzumab was profound and comparable to that seen in a group of renal transplant recipients who had received intravenous Alemtuzumab. Subcutaneous Alemtuzumab was associated with similar rates of acute rejection (14% at 1 year), patient survival (100%), and pancreas and kidney graft survival (95% and 100%, respectively) to those observed in centers using intravenous Alemtuzumab in simultaneous pancreas kidney transplantation. There was no excess incidence of adverse events. We therefore recommend this route of administration to all transplant centers using Alemtuzumab.