Treatment of Steroid-Resistant Acute Renal Allograft Rejection With Alemtuzumab

M. W. F. van den Hoogen*, D. A. Hesselink, W. J. van Son, W. Weimar, L. B. Hilbrands

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    30 Citations (Scopus)

    Abstract

    Steroid-resistant renal allograft rejections are commonly treated with rabbit antithymocyte globulin (RATG), but alemtuzumab could be an effective, safe and more convenient alternative. Adult patients with steroid-resistant renal allograft rejection treated with alemtuzumab (1530 mg s.c. on 2 subsequent days) from 2008 to 2012 (n = 11) were compared to patients treated with RATG (2.5-4.0 mg/kg bodyweight i.v. for 1014 days; n = 20). We assessed treatment-failure (graft loss, lack of improvement of graft function or need for additional anti-rejection treatment), infections during the first 3 months after treatment and infusion-related side effects. In both groups, the median time-interval between rejection and transplantation was 2 weeks, and approximately 75% of rejections were classified as Banff-IIA or higher. Three alemtuzumab-treated patients (27%) experienced treatment failure, compared to eight RATG treated patients (40%, p = 0.70). There was no difference in the incidence of infections. There were mild infusion-related side-effects in three alemtuzumab-treated patients (27%), and more severe infusion-related side effects in 17 RATG-treated patients (85%, p = 0.013). Drug related costs of alemtuzumab-treatment were lower than of RATG-treatment ((sic)1050 vs. (sic)2024; p <0.01). Alemtuzumab might be an effective therapy for steroid-resistant renal allograft rejections. In contrast to RATG, alemtuzumab is nearly devoid of infusion-related side-effects. These data warrant a prospective trial.

    Original languageEnglish
    Pages (from-to)192-196
    Number of pages5
    JournalAmerican Journal of Transplantation
    Volume13
    Issue number1
    DOIs
    Publication statusPublished - Jan-2013

    Keywords

    • Alemtuzumab
    • antithymocyte globulin
    • renal allograft rejection
    • steroid resistant
    • KIDNEY-TRANSPLANT RECIPIENTS
    • RANDOMIZED-TRIAL
    • CAMPATH-1H
    • THERAPY
    • INDUCTION
    • ANTIBODY

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