| Indication |
- Induction therapy in renal, small bowel and kidney/pancreas transplantation in adults
- Unlicensed product, previous brand name - Campath®
- After alemtuzumab induction therapy, maintenance immunosuppressive therapy must be undertaken
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| Preparations |
- Humanised IgG1 monoclonal anti-CD52 antibody
- Intravenous: injection 30mg vials
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| Contraindications |
None
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| Cautions |
- Monitor full blood counts (FBC)
- Monitor liver function tests (LFT)
- There is an increased risk of lymphoproliferative disorders (LPDs; such as lymphoma) and opportunistic infections such as CMV and BKV. Monitor patients for the above
- Administer PCP and CMV prophylaxis for 6 month after treatment or monitor PCR for CMV infection. Also antifungal prophylaxis for 1 month
Patients who have received alemtuzumab must only receive irradiated blood
As with all patients post transplant:
- Monitor for donor-specific antibodies (DSA): at 1 and 3 months and every 3 months following transplant using ELISA and Luminex
- Monitor lymphocyte numbers: at 1 and 3 months and every 3 months following transplant until counts return to ≥200 cells/µL
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| Side-effects |
- Cytopenias: anaemia, lymphopenia, neutropenia and thrombocytopenia. There is an increased risk of pancytopenia with doses higher than 30mg of alemtuzumab
- Infusion reactions: tachycardia, hypotension, pyrexia, dyspnea, urticaria, nausea, rash, chills
- Increased risk of infection and malignancies: CMV, BKV, herpes zoster, urinary tract infections, skin cancer and other cancers
- Gastrointestinal symptoms: nausea, abdominal pain, diarrhoea
- Neurological symptoms: anxiety, insomnia
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| Dose |
Pre-medications before alemtuzumab treatment:
- Methylprednisolone 500mg - 1g IV
- Chlorphenamine 10mg IV – 30 minutes before alemtuzumab
- Paracetamol 1g orally - 30 minutes before alemtuzumab
Alemtuzumab: 30mg by subcutaneous injection at the time of transplant
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| Dose in renal impairment |
Use with caution, unlikely to be dialysed
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| Interactions |
- Avoid other chemotherapy agents within three weeks of each other
- Avoid live vaccines for at least 12 months after treatment
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| How to Prescribe |
View Details |
| Patient comment |
- Avoid live vaccines
- Increased risk of infection and cancers – report any symptoms
- Infusion reactions – report any symptoms
- Cytopenias – report any symptoms
- Store in a refrigerator
- Advise male and female patients with reproductive potential to use effective contraceptive methods during treatment and for a minimum of 6 months after alemtuzumab treatment
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