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- Title
Infectious complications associated with alemtuzumab use for allogeneic hematopoietic stem cell transplantation: comparison with anti-thymocyte globulin.
- Authors
Park, S. H.; Choi, S.-M.; Lee, D.-G.; Choi, J.-H.; Yoo, J.-H.; Kim, S.-H.; Kim, H.-J.; Cho, S.-G.; Eom, K.-S.; Lee, J.-W.; Min, W.-S.; Shin, W.-S.; Kim, C.-C.
- Abstract
Objectives. To evaluate the incidence of infectious complications after receiving alemtuzumab as part of a conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in Korean patients. Methods. From November 2004 to January 2006, 12 patients who received alemtuzumab-based conditioning regimens for allogeneic HSCT were evaluated retrospectively until death or until the end of the follow-up in July 2007; they were compared with 18 patients who received rabbit anti-thymocyte globulin (ATG)-containing conditioning regimens from January 2002 to January 2006. Results. Post-engraftment infections occurred more frequently in the alemtuzumab recipients than in the ATG recipients; the mean number of infections, excluding cytomegalovirus (CMV) infections, per patient during the follow-up period was 2.6±1.4 vs. 1.0±0.8 ( P=0.003), respectively. Although there was no statistical difference in the cumulative incidence of CMV infection between the 2 groups (91.7% vs. 55.6%, P=0.381), the alemtuzumab recipients had a higher incidence of CMV diseases (41.6% vs. 0%, P=0.0006) and a higher recurrence rate of CMV infection (90.0% vs. 27.3%, P=0.008) than did the ATG recipients, irrespective of the dose of alemtuzumab. Hemorrhagic cystitis (HC) (66.7% vs. 16.7%, P=0.009) and BK virus-associated HC (41.7% vs. 5.6%, P=0.026) developed more frequently in the alemtuzumab recipients. The all-cause mortality rate was not significantly different between the alemtuzumab and the ATG recipients (75% vs. 55.6%, P=0.28). Conclusion. Alemtuzumab recipients had a high incidence of CMV disease as well as BK virus-associated HC compared with the ATG recipients. The dose of alemtuzumab should be tailored to patients' risk; in addition, the implementation of the appropriate prophylaxis for CMV and early detection strategies for BK virus are recommended.
- Subjects
HEMATOPOIETIC stem cell transplantation; CYTOMEGALOVIRUS diseases; GLOBULINS; HLA histocompatibility antigens; GRAFT versus host disease
- Publication
Transplant Infectious Disease, 2009, Vol 11, Issue 5, p413
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/j.1399-3062.2009.00414.x