Campath-1H (Alemtuzumab) as an Induction Agent for the Prevention of Graft Rejection and Preservation of Renal Function in Kidney Transplant Patients: Philippine 3-Year Follow-up

Muñoz, Angélica; Cabanayan-Casasola, C.B.; Danguilan, Romina; Padua, F.B.; Ona, E.T.

doi:10.1016/j.transproceed.2008.07.085

Cited by 7 publications

(3 citation statements)

References 6 publications

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“…Despite the long-lasting CD4 T cell depletion (15) for over 1 year mortality due to infection was not increased in alemtuzumab patients. This finding is somewhat surprising and confirms reports in other publications (16,17) with a lack of opportunistic infections when it was used as induction agent. Similar to data reported by McCurry et al (10,11), none of our patients developed early posttransplant lymphoproliferative disorder (PTLD) despite aggressive T cell depletion.…”

Section: Discussionsupporting

confidence: 85%

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Jaksch

Ankersmit

Scheed

et al. 2014

American Journal of Transplantation

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Induction therapy with alemtuzumab followed by lower maintenance immunosuppression (IS) has been associated with reduced morbidity and mortality in abdominal and heart transplantation (TX). In the current study, alemtuzumab, in combination with reduced levels of maintenance IS, was compared to thymoglobulin in combination with standard IS. Sixty consecutive patients who underwent lung transplantation (LUTX) at a single center were prospectively randomized in two groups: group A received alemtuzumab in conjunction with reduced doses of tacrolimus, steroids and mycophenolate mofetil. Group B received thymoglobulin in association with standard dose IS. Patient and graft survival, freedom from acute cellular rejection (ACR), lymphocytic bronchiolitis, bronchiolitis obliterans syndrome, kidney function, infectious complications and posttransplant lymphoproliferative disorder were analyzed. Alemtuzumab induction therapy resulted in complete the absence of ACR episodes ! A2 within the first year post-TX. The difference to thymoglobulin was significant (alemtuzumab 0 vs. ATG 0.33; p ¼ 0.019). All other factors studied did not show any differences between the two groups. Alemtuzumab induction therapy after LUTX in combination with reduced maintenance IS significantly reduces higher-grade rejection rates. This novel therapeutic agent had no impact on survival, infections rates, kidney function and incidence of malignancies.

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Section: Discussionsupporting

confidence: 85%

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Jaksch

Ankersmit

Scheed

et al. 2014

American Journal of Transplantation

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“…123 The third and largest randomized controlled trial was conducted by Margreiter et al in 2008. A total of 131 kidney transplant patients were randomized to alemtuzumab with delayed tacrolimus or triple therapy (tacrolimus, MMF, steroids).…”

Section: Resultsmentioning

confidence: 99%

Antibody immunosuppressive therapy in solid-organ transplant

Mahmud

Klipa

Ahsan

2010

mAbs

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“…However, there appears to be a trend towards lower acute rejection rates in groups using alemtuzumab induction [66,67,[73][74][75][76][77] , particularly in association with tacrolimus maintenance therapy. The choice of calcineurin-inhibitor is also important when using monoclonal antibody for induction as acute rejections are temporally delayed [73,78,79] . It has been shown that a stable graft during the initial days results in better outcomes later [80] , highlighting the potential importance of alemtuzumab.…”

Section: Alemtuzuamb In Renal Transplantationmentioning

confidence: 99%

Immunomodulator alemtuzumab therapy in kidney transplantation

2016

Macrophage

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Owing to an insufficient understanding of molecular mechanisms, currently the best treatment available for chronic kidney failure is transplantation. There is a heightened need for effective immunosuppressants to counteract rejection. Alemtuzumab, a humanized anti-CD52 antibody, is a powerful lymphocyte-depleting agent. Recently, it has been increasingly used as induction therapy in renal transplantation but its role is not yet fully defined. Indications that early withdrawal of corticosteroids in kidney transplant patients is associated with a better prognosis, has necessitated a hunt for an effective induction agent that supports early corticosteroid withdrawal. In this regard, alemtuzumab is an attractive agent because of its prolonged lymphocyte depleting properties. Long-term studies in kidney transplant patients are still needed for it to be considered as an effective induction agent. Trends in lower acute rejection rates in groups using alemtuzumab induction, particularly in association with tacrolimus maintenance therapy, have been noted and acute rejections were not as severe. Lymphocyte depletion is expected to be associated with an increased incidence of infection and any new immunosuppressive agents should be observed closely for development of infection. Initial studies have not established increased infection rates with alemtuzumab induction, possibly because of the preservation of function of the remaining T-lymphocytes other than CD4+ cells. Further randomized control trials with larger populations are needed to draft a protocol for alemtuzumab's more effective use in transplantation.

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Campath-1H (Alemtuzumab) as an Induction Agent for the Prevention of Graft Rejection and Preservation of Renal Function in Kidney Transplant Patients: Philippine 3-Year Follow-up

Cited by 7 publications

References 6 publications

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Alemtuzumab in Lung Transplantation: An Open-Label, Randomized, Prospective Single Center Study

Antibody immunosuppressive therapy in solid-organ transplant

Immunomodulator alemtuzumab therapy in kidney transplantation

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