Alemtuzumab infection risk

Thursky KA et al. Spectrum of infection, risk and recommendations for prophylaxis and screening among patients with lymphoproliferative disorders treated with alemtuzumab. British Journal of Haematology 2006 132 3-12. 

Infection risk In a study of consolidation therapy with subcutaneous alemtuzumab after fludarabine and rituximab induction therapy for previously untreated chronic lymphocytic leukemia, alemtuzumab was associated with five deaths resulting from infections (viral, Listeria meningitis and Legionella, cytomegalovirus, and Pneumocystis jirovedi pnemnonia), which occurred up to 7 months after the last administration [bS "]. 

Infection risk In a retrospective comparison of infections in solid organ transplant recipients receiving alemtuzumab or basiliximab ( = 215), basiliximab posed a higher risk of infections than alemtuzumab 33% of the former (240/724) compared with 40% (87/215) of the latter (OR = 0.72 95% Cl = 0.53, 0.99) [71 ]. The frequency of fungal infections, mostly caused by Candida species, was similar in the two groups (10% versus 9%) disseminated fungal infections occurred in 68% versus 30% (OR = 4.8 95% CI=1.6,14). 

Infection risk Recurrent oral herpes simplex virus type 1 was seen in 1.4% of patients with multiple sclerosis immediately after each cycle of alemtuzumab [138 ]. Inactive tuberculosis was incidentally identified in one patient who received alemtuzumab 24 mg. There were no cases of progressive multifocal leukoencephalo-pathy, cytomegalovirus infection, or pneu-mocystis pneumonia. 

Alemtuzumab An+, D+, G+, M++ Can cause severe prolonged lymphopenia. Serious risk of fatal bacterial or opportunistic infections. 

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