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Alemtuzumab
See also Monoclonal antibodies
General information
Alemtuzumab (campath-1H) is a humanized monoclonal antibody specific for the CDw52 antigen, present on cell membranes of lymphocytes and monocytes. It has been used for treatment of patients with rheumatoid arthritis and vasculitis, is being investigated for the treatment of chronic lymphocytic leukemia, and has been used to deplete circulating lymphocytes in patients with multiple sclerosis [ ]. In 2001, alemtuzumab was approved in Europe for the treatment of chronic B cell lymphocytic leukemia that had been treated previously with alkylating agents and was refractory to fludarabine [ ]. It has also been used for induction of immunosuppression/tolerance in liver transplant recipients [ , ] and kidney/pancreas transplant recipients [ ].
The major adverse effects (fever, nausea, skin rash, and hypotension) may well be related to the release of cytokines as a consequence of lysis of the target lymphocytes [ ]. Of four patients treated with alemtuzumab, three developed antibodies against it, but without affecting the plasma concentrations and without obvious clinical consequences. Other adverse effects have included mild renal impairment and transient thrombocytopenia.
Drug studies
Observational studies
On 19 September 2007 alemtuzumab was approved by the FDA as a single agent for the treatment of B-cell chronic lymphocytic leukemia. The common reported adverse effects in the CAM 307 trial include lymphopenia (99%), neutropenia (77%), anemia (76%), thrombocytopenia (71%), pyrexia (69%), chills (53%), cytomegalovirus viremia (56%), and cytomegalovirus infection (16%) [ ]. Other infections were reported in 90% of subjects. Skin manifestations included urticaria (16%), other rashes (13%), and erythema (4%). There was also hypotension (16%), hypertension (14%), headache (14%), tremor (3%), dyspnea (14%), diarrhea (10%), insomnia (10%), anxiety (8%), and tachycardia (10%).
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