Use of Alemtuzumab (Campath-1H) as Induction Therapy in Pediatric Kidney Transplantation

Ona, E.T.; Danguilan, Romina; Africa, Joseph; Cabanayan-Casasola, C.B.; Antonio, Zenaida L.; Gutierrez-Marbella, M.A.; Cruz, Ramon; Bumanglag, N.; Espedilla, M.E.

doi:10.1016/j.transproceed.2008.07.050

Cited by 23 publications

(12 citation statements)

References 11 publications

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“…Alemtuzumab is a humanized monoclonal anti‐CD52 antibody that was developed as an immunosuppressive agent that depletes T cells, and it is a potential therapy against lymphoid disease 12, 13. The therapy has been used successfully in various induction protocols for solid organ transplantation 14‐18. Similarly, alemtuzumab has been used as a conditioning agent for stem cell transplantation and also as a prophylactic agent against graft‐versus‐host disease 19‐22…”

Section: Resultsmentioning

confidence: 99%

“…12,13 The therapy has been used successfully in various induction protocols for solid organ transplantation. [14][15][16][17][18] Similarly, alemtuzumab has been used as a conditioning agent for stem cell transplantation and also as a prophylactic agent against graftversus-host disease. [19][20][21][22] Alemtuzumab is currently approved by the US Food and Drug Administration for monotherapy in chronic lymphocytic leukemia.…”

Section: Resultsmentioning

confidence: 99%

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Successful treatment of refractory metastatic histiocytic sarcoma with alemtuzumab

Shukla

Kobos

Renaud

et al. 2011

Cancer

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BACKGROUND: Histiocytic sarcoma (HS) is an exceedingly rare tumor and carries a dismal prognosis when patients present with advanced‐stage disease. Because of the poor response rates to conventional chemotherapy and the rarity of the disease, no standard of care exists for patients with HS. The authors report the single‐agent use of the anti‐CD52 antibody alemtuzumab in 2 patients who had advanced‐stage HS. METHODS: Two patients with chemotherapy‐refractory, metastatic HS with tumors that expressed the CD52 antigen received a prolonged course of treatment with the anti‐CD52 monoclonal antibody alemtuzumab. RESULTS: Resected tumor samples from both patients demonstrated CD52 expression. Both patients had marked responses to single‐agent alemtuzumab. One patient had a complete response with no evidence of disease for >5 years. The second patient had a major response to alemtuzumab and also remained alive with no evidence of disease for >4 years. CONCLUSIONS: Further studies need to be performed to examine CD52 expression and function in HS as well as the role of alemtuzumab in a larger cohort of patients. However, the clinical impact of single‐agent alemtuzumab in the 2 patients described in this report was very encouraging. Given the toxicity and frequent inefficacy of conventional chemotherapy, patients with incompletely resected HS should be strongly considered for alemtuzumab therapy. Cancer 2012. © 2011 American Cancer Society.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Successful treatment of refractory metastatic histiocytic sarcoma with alemtuzumab

Shukla

Kobos

Renaud

et al. 2011

Cancer

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“…A new lymphocyte-depleting agent, alemtuzumab (Campath-1H), which is a monoclonal antibody directed against CD52-positive B and T lymphocytes, has been used as an induction agent in adult renal transplantation. Initial results of its use as an induction agent in low-risk pediatric patients followed by a steroidfree regimen consisting of a calcineurin inhibitor and MMF have been encouraging [42]. Tan et al [43] report excellent graft survival rates with tacrolimus monotherapy in combination with Campath-1H induction in 42 living donor pediatric kidney transplants, implying that this agent holds promise for minimization regimes in children.…”

Section: Immunosuppressionmentioning

confidence: 99%

Pediatric renal transplantation: an overview and update

Gulati

Sarwal²

2010

Current Opinion in Pediatrics

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This review presents a comprehensive discussion of the major issues in pediatric renal transplantation, the newer immunosuppression approaches to limit toxicities of therapies in children and some critical issues that remain to be addressed, specific to the care of the transplanted child. The ultimate goal of designing optimum conditions for equating graft survival to patient survival still remains a major goal for pediatric organ transplantation.

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“…During this period, the use of alemtuzumab in children was very limited, and steroid avoidance had not been proven safe and effective until 2012 . Furthermore, there were insufficient retrospective studies which have evaluated outcomes of alemtuzumab induction in pediatric renal transplantation . Among these reports, there was significant variability in acute rejection rates, which ranged from 0 to 75%.…”

Section: Discussionmentioning

confidence: 99%

Alemtuzumab with corticosteroid minimization for pediatric deceased donor renal transplantation: A seven‐yr experience

Supe-Markovina

Melquist

Connolly

et al. 2014

Pediatric Transplantation

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Alemtuzumab is a monoclonal antibody targeting CD52 receptors on B and T lymphocytes and is an effective induction agent in pediatric renal transplantation. We report a seven-yr experience using alemtuzumab induction and steroid-free protocol in the pediatric population as safe and effective. Twenty-one pediatric deceased donor renal transplants were performed at a single academic institution. All received induction with single-dose alemtuzumab and were maintained on a steroid-free protocol using TAC and MMF immunosuppression. There were 15 males and six females in the study whose ages ranged from one to 19 yr. The average follow-up was 32 months (range from 12 to 78.2 months and median 33.7 ± 23.7 months). All patients had immediate graft function. Graft survival was 95%, and patient survival was 100%. Mean 12 and 36 months eGFR were 63.33 ± 21.01 and 59.90 ± 15.27 mL/min/1.73m(2), respectively. Three patients developed acute T-cell-mediated rejection due to non-adherence while no recipients developed cytomegalovirus infection, PTLD, or polyoma BK viral nephropathy. Steroid avoidance with single-dose alemtuzumab induction provides adequate and safe immunosuppression in pediatric deceased donor renal transplant recipients receiving TAC and low-dose MMF maintenance therapy.

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Use of Alemtuzumab (Campath-1H) as Induction Therapy in Pediatric Kidney Transplantation

Cited by 23 publications

References 11 publications

Successful treatment of refractory metastatic histiocytic sarcoma with alemtuzumab

Successful treatment of refractory metastatic histiocytic sarcoma with alemtuzumab

Pediatric renal transplantation: an overview and update

Alemtuzumab with corticosteroid minimization for pediatric deceased donor renal transplantation: A seven‐yr experience

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