Alemtuzumab (CAMPATH-1H) for the treatment of acute rejection in kidney transplant recipients: long-term follow-up

Transplantation. 2009 Apr 15;87(7):1092-5. doi: 10.1097/TP.0b013e31819d3353.

Abstract

Background: Alemtuzumab (MabCampath, Campath-1H) is a lymphocyte-depleting monoclonal antibody increasingly used in renal transplantation. This article reports the long-term follow-up data from the first series of patients treated with alemtuzumab for biopsy-proven acute rejection (BPAR).

Methods: Fifteen patients were identified who had received alemtuzumab for BPAR between November 1991 and June 1994. Patient and allograft survival were compared with a control group consisting of 25 patients with BPAR from the same era treated with intravenous methyl prednisolone, and with a contemporaneous UK renal transplant cohort.

Results: All rejection episodes responded to treatment with alemtuzumab but there was an excess of early infection-associated death in this group. Long-term transplant survival was similar in both groups as was allograft function (mean creatinine concentration at 10 years was 143 micromol/L in alemtuzumab cohort and 183 micromol/L in control cohort, P=0.06). There was no excess incidence of malignancy or cytomegalovirus infection in this prolonged follow-up period.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alemtuzumab
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal / toxicity
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm / therapeutic use*
  • Antibodies, Neoplasm / toxicity
  • Antineoplastic Agents / therapeutic use
  • Cadaver
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Graft Rejection / drug therapy*
  • Graft Rejection / epidemiology
  • Graft Rejection / immunology*
  • Graft Rejection / mortality
  • Humans
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / immunology*
  • Living Donors
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Time Factors
  • Tissue Donors

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antibodies, Neoplasm
  • Antineoplastic Agents
  • Alemtuzumab
  • Methylprednisolone