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Alemtuzumab is a powerful lymphocyte depleting antibody currently being evaluated in solid organ transplantation. This paper describes 5-year results of a single center study of alemtuzumab as induction in renal transplantation. Thirty-three renal transplant recipients received 20 mg alemtuzumab on day 0 and 1, followed by half-dose cyclosporin monotherapy (trough concentration 75-125 ng/mL) from day 3. They were compared in a retrospective contemporaneous-controlled manner with 66 kidney transplant recipients transplanted in the same period and center who received conventional immunosuppression with cyclosporin, azathioprine and prednisolone. In the alemtuzumab group 12% of recipients died compared to 17% in the control group (p = 0.48); likewise graft loss was similar in both groups (21% vs. 26%, respectively, p = 0.58). Incidence of acute rejection was also comparable at 5 years (31.5% vs. 33.6%), although the pattern of rejection was different with 14% patients in the alemtuzumab group experiencing rejection over 1 year post-transplant compared to none in the control group. There was no significant difference between groups in terms of infection or serious adverse events. While acknowledging the limitations of a relatively small single-center study, results suggest that alemtuzumab induction allowed satisfactory long-term patient and graft survival equivalent to that seen with standard triple immunosuppression, while avoiding steroid therapy.

Original publication

DOI

10.1111/j.1600-6143.2005.00822.x

Type

Journal article

Journal

Am J Transplant

Publication Date

06/2005

Volume

5

Pages

1347 - 1353

Keywords

Adult, Aged, Alemtuzumab, Anti-Inflammatory Agents, Antibodies, Monoclonal, Antibodies, Monoclonal, Humanized, Antibodies, Neoplasm, Antineoplastic Agents, Azathioprine, Cyclosporine, Drug Therapy, Combination, Female, Follow-Up Studies, Graft Survival, Humans, Immunosuppressive Agents, Kidney Transplantation, Male, Middle Aged, Postoperative Complications, Prednisolone, Remission Induction, Retrospective Studies, Safety, Time Factors, Treatment Outcome