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Last updated: Acute Kidney Injury…
on 10 Apr 2017

Alemtuzumab (Campath®)



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
Preparations
  • Humanised IgG1 monoclonal anti-CD52 antibody
  • Intravenous: injection 30mg vials
Contraindications

None

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
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
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

Dose in renal impairment

Use with caution, unlikely to be dialysed

Interactions
  • Avoid other chemotherapy agents within three weeks of each other
  • Avoid live vaccines for at least 12 months after treatment
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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